15,916 results match your criteria Delirium


Neurofilament Light in the Serum and Cerebrospinal Fluid of Hip Fracture Patients with Delirium.

Dement Geriatr Cogn Disord 2018 Dec 6;46(5-6):346-357. Epub 2018 Dec 6.

Oslo Delirium Research Group, Department of Geriatric Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Background: Delirium is associated with new-onset dementia, suggesting that delirium pathophysiology involves neuronal injury. Neurofilament light (NFL) is a sensitive biomarker for neuroaxonal injury.

Methods: NFL was measured in cerebrospinal fluid (CSF) (n = 130), preoperative serum (n = 192), and postoperative serum (n = 280) in hip fracture patients, and in CSF (n = 123) and preoperative serum (n = 134) in cognitively normal older adults undergoing elective surgery. Read More

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December 2018
2 Reads

Comparison of electroencephalogram (EEG) response to MDPV versus the hallucinogenic drugs MK-801 and ketamine in rats.

Exp Neurol 2018 Dec 3. Epub 2018 Dec 3.

Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA. Electronic address:

Synthetic cathinones, often marketed as 'bath salts', have been reported to induce an excited delirium syndrome with characteristic symptoms such as paranoid, hallucination and even aggression. 3,4-Methylenedioxypyrovalerone (MDPV), a norepinephrine-dopamine reuptake inhibitor (NDRI), is one of the psychoactive ingredients in bath salts. The present study utilized cortical EEG and brain microdialysis in rats to compare the effects of MDPV (0. Read More

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December 2018

Continuous improvement process: ortho-geriatric co-management of proximal femoral fractures.

Arch Orthop Trauma Surg 2018 Dec 5. Epub 2018 Dec 5.

Department of Orthopaedic and Trauma Surgery, Robert-Bosch-Krankenhaus Stuttgart, Auerbachstrasse 110, 70376, Stuttgart, Germany.

Objective: The objective of the current study was to evaluate the effect of a quality management system on treatment and care delivery of proximal femoral fractures. Specifically, our hypothesis was that the "plan-do-check-act (PDCA)" philosophy of the ISO 9001 quality management system results in a continuous improvement process.

Methods: 1015 proximal femoral fractures were prospectively included into a hip fracture database over a 5-year period, after a restructuring process with implementation of clinical pathways and standard operation procedures. Read More

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December 2018

Postoperative cognitive dysfunction - current preventive strategies.

Clin Interv Aging 2018 8;13:2267-2273. Epub 2018 Nov 8.

Department of Surgery, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.

Improving trends in global health care have resulted in a steady increase in the geriatric population. However, as the population ages, surgery is being performed more frequently in progressively older patients and those with higher prevalence of comorbidities. A significant percentage of elderly patients experience transient postoperative delirium following surgery or long-term postoperative cognitive dysfunction (POCD). Read More

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November 2018

Effect of regional versus general anaesthesia on postoperative delirium in elderly patients undergoing surgery for hip fracture: a systematic review.

BMJ Open 2018 Dec 4;8(12):e020757. Epub 2018 Dec 4.

Warwick Medical School, University of Warwick, Coventry, UK.

Objective: Older patients with hip fractures who are undergoing surgery are at high risk of significant mortality and morbidity including postoperative delirium. It is unclear whether different types of anaesthesia may reduce the incidence of postoperative delirium. This systematic review will investigate the impact of anaesthetic technique on postoperative delirium. Read More

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December 2018

Role of perceived stress in postoperative delirium: an investigation among elderly patients.

Aging Ment Health 2018 Dec 6:1-7. Epub 2018 Dec 6.

c Division of Surgical Critical Care and Trauma, Department of Surgery, Maharaj Nakorn Chiang Mai Hospital , Chiang Mai , Thailand.

Objectives: This study examined levels of perceived stress (PS), postoperative delirium (POD) and associated factors among Thai elderly patients undergoing elective noncardiac surgery.

Background And Aims: Preoperative PS and change after operation have not been widely studied. Moreover, psychological factors associated with PS and POD has been poorly investigated. Read More

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December 2018

Cognitive changes in older women after urogynaecological surgery.

Ginekol Pol 2018 ;89(11):587-592

Frauenzimmer Bern AG, Bern, Switzerland.

Objectives: The need for pelvic floor surgery will increase with an aging population in the future. Aim of this prospective study was to evaluate the evolution of cognitive function in elderly women after urogynaecological surgery.

Material And Methods: Between 2010 and 2014, 51 female patients 70 years and older who underwent urogynaecological surgery participated in this study. Read More

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January 2018

What is the appropriate communication style for family members confronting difficult surrogate decision-making in palliative care?: A randomized video vignette study in medical staff with working experiences of clinical oncology.

Jpn J Clin Oncol 2018 Dec 1. Epub 2018 Dec 1.

Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan.

Background: The family members of terminally ill patients are often requested to make difficult surrogate decisions during palliative care. This study sought to clarify the appropriate communication style for physicians as perceived by family members confronting difficult surrogate decision-making.

Methods: This experimental psychological study used scripted videos. Read More

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December 2018

2018 Update on Medical Overuse.

JAMA Intern Med 2018 Dec 3. Epub 2018 Dec 3.

Department of Medicine and Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, New York.

Importance: Overuse of medical care is a well-recognized problem in health care, associated with patient harm and costs. We sought to identify and highlight original research articles published in 2017 that are most relevant to understanding medical overuse.

Observations: A structured review of English-language articles published in 2017 was performed, coupled with examination of tables of contents of high-impact journals to identify articles related to medical overuse in adult care. Read More

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December 2018
5 Reads

Prediction of ICU Delirium: Validation of Current Delirium Predictive Models in Routine Clinical Practice.

Crit Care Med 2018 Nov 30. Epub 2018 Nov 30.

Department of Intensive Care Medicine, Peninsula Health, Frankston, VIC, Australia.

Objectives: To investigate the ability of available delirium risk assessment tools to identify patients at risk of delirium in an Australian tertiary ICU.

Design: Prospective observational study.

Setting: An Australian tertiary ICU. Read More

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November 2018

Neuromonitoring in the elderly.

Curr Opin Anaesthesiol 2018 Nov 29. Epub 2018 Nov 29.

Department of Anesthesiology and Operative Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Purpose Of Review: To summarize recent recommendations on intraoperative electroencephalogram (EEG) neuromonitoring in the elderly aimed at the prevention of postoperative delirium and long-term neurocognitive decline. We discuss recent perioperative EEG investigations relating to aging and cognitive dysfunction, and their implications on intraoperative EEG neuromonitoring in elderly patients.

Recent Findings: The incidence of postoperative delirium in elderly can be reduced by monitoring depth of anesthesia, using an index number (0-100) derived from processed frontal EEG readings. Read More

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November 2018
2 Reads

Biomarkers and postoperative cognitive function: could it be that easy?

Curr Opin Anaesthesiol 2018 Nov 29. Epub 2018 Nov 29.

Department of Anaesthesiology, University Hospital, LMU Munich, Munich.

Purpose Of Review: Neurocognitive dysfunction after surgery is highly relevant in the elderly. The multifactorial manner of this syndrome has made it hard to define an ideal biomarker to predict individual risk and assess diagnosis and severity of delirium [postoperative delirium (POD)] and subsequent postoperative cognitive decline (POCD). This review summarizes recent literature on blood biomarkers for POD/POCD. Read More

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November 2018

Clinical Education to Decrease Perceived Barriers to Delirium Screening in Adult Intensive Care Units.

Crit Care Nurs Q 2019 Jan/Mar;42(1):41-43

Medical University of South Carolina, Charleston.

Despite current advances in critical care medicine, delirium remains a frequent complication of an intensive care unit stay. The consequences can be severe and far reaching, including an increase in mortality, length of stay, and long-term cognitive sequelae. Frequently, delirium can be missed by clinicians who fail to complete a standardized delirium screening tool and, therefore, many cases go unrecognized and untreated. Read More

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December 2018

Recognition, Assessment, and Pharmacotherapeutic Treatment of Alcohol Withdrawal Syndrome in the Intensive Care Unit.

Crit Care Nurs Q 2019 Jan/Mar;42(1):12-29

Department of Pharmacy Services, UC Health-University of Cincinnati Medical Center, Ohio (Drs Foertsch, Winter, Droege, and Ernst); University of Cincinnati James L. Winkle College of Pharmacy, Ohio (Drs Foertsch, Winter, Rhoades, Martin, Droege, and Ernst); Department of Pharmacy Services, The Christ Hospital Health Network, Cincinnati, Ohio (Dr Rhoades); and Department of Pharmacy Services, St Elizabeth Healthcare, Edgewood, Kentucky (Dr Martin).

Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit varies, but has been associated with poor outcomes. This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. Read More

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December 2018

Understanding our patients better will lead to better recognition of delirium: An opinion piece.

Australas J Ageing 2018 Dec;37(4):241-242

School of Medicine, Griffith University, Gold Coast, Queensland, Australia.

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December 2018

The effectiveness of non-pharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta-analysis.

Intensive Care Med 2018 Nov 30. Epub 2018 Nov 30.

School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.

Purpose: To evaluate the effect of non-pharmacological interventions versus standard care on incidence and duration of delirium in critically ill patients.

Methods: We searched electronic and grey literature for randomised clinical trials up to March 2018. Two reviewers independently screened, selected and extracted data. Read More

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November 2018

Dispersion in Scores on the Richmond Agitation and Sedation Scale as a Measure of Delirium in Patients with Subdural Hematomas.

Neurocrit Care 2018 Nov 30. Epub 2018 Nov 30.

Division of Critical Care Neurology, Department of Neurology, Columbia University Medical Center, Milstein Hospital Building, 177 Fort Washington Avenue, 8-300 Center, New York, NY, 10032, USA.

Background: Delirium is a frequent complication of critical illness, but its diagnosis is more difficult in brain-injured patients due to language impairment and disorders of consciousness. We conducted a prospective cohort study to determine whether Richmond Agitation and Sedation Scale (RASS) scores could be used to reliably diagnose delirium in the setting of brain injury. We also examined clinical factors associated with delirium in patients with subdural hematomas (SDH) and assessed its impact on functional outcome at discharge. Read More

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November 2018

Recent advances in non-surgical management of cancer in the elderly.

F1000Res 2018 15;7. Epub 2018 Nov 15.

Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA.

This article summarizes the seminal publications from mid-2016 through 2017 in the area of medical care for older adults with cancer. Areas addressed include chemotherapy tolerance and efficacy in the aged, geriatric fitness assessments, and advancements in palliative and supportive care. The practice-changing finding from this past year's publications is that antipsychotics should not be used in the management of terminal delirium in older adults receiving palliative care. Read More

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November 2018

A team approach to the introduction of safe early mobilisation in an adult critical care unit.

BMJ Open Qual 2018 10;7(4):e000339. Epub 2018 Nov 10.

Department of Intensive Care, Monklands Hospital, Airdrie, North Lanarkshire, UK.

Delirium and intensive care unit acquired weakness are common in patients requiring critical care and associated with higher mortality and poor long-term outcomes. Early mobilisation has been shown to reduce the duration of both conditions and is recommended as part of a strategy of rehabilitation of critically ill patients starting during their stay in intensive care. Our aim was to achieve 95% reliability with a standardised mobilisation process. Read More

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November 2018

The Motoric Types of Delirium and Estimated Blood Loss during Perioperative Period in Orthopedic Elderly Patients.

Biomed Res Int 2018 1;2018:9812041. Epub 2018 Nov 1.

Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang-si, Republic of Korea.

Background: Delirium is a common and serious syndrome in elderly patients. The hypoactive type of delirium is known to have different characteristics, but further studies are needed to define the specificities of these characteristics. Our study aims at finding specific risk factors, especially estimated blood loss during operations of hyper- and hypoactive delirium in orthopedic elderly patients. Read More

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November 2018
2 Reads

Dynamic cerebral autoregulation: A marker of post-operative delirium?

Clin Neurophysiol 2018 Nov 22;130(1):101-108. Epub 2018 Nov 22.

Department of Cardiopneumology, University of Sao Paulo, Brazil.

Objective: We investigated the potential association of cerebral autoregulation (CA) with postoperative delirium (PD), a common complication of cardiac surgery with cardiopulmonary bypass (CPB).

Methods: In patients undergoing coronary artery bypass graft (CABG) surgery with CPB, cerebral blood flow velocity (CBFV) and blood pressure (BP) were continuously recorded during 5-min preoperatively (T1), after 24 h (T2), and 7 days after procedure (T3). Prospective multivariate logistic regression analysis was performed to determine the independent risk factors of PD. Read More

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November 2018

Effect of anticholinergic burden on treatment modification, delirium and mortality in newly diagnosed dementia patients starting a cholinesterase inhibitor: a population-based study.

Basic Clin Pharmacol Toxicol 2018 Dec 3. Epub 2018 Dec 3.

College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.

Few studies have evaluated the association between anticholinergic burden and treatment modification after starting a cholinesterase inhibitor in clinical practice. We aimed to evaluate the effect of anticholinergic burden on anti-dementia treatment modification, delirium and mortality. We retrospectively analysed older adults (n = 25,825) who started a cholinesterase inhibitor during 2003-2011 from Korean National Health Insurance Service Senior Cohort Database. Read More

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December 2018

Pharmacists' interventions to reduce sedative/hypnotic use for insomnia in hospitalized patients.

Saudi Pharm J 2018 Dec 20;26(8):1204-1207. Epub 2018 Jul 20.

University of Arizona College of Pharmacy, USA.

Background: Hospitalization can contribute to insomnia in many patients and is usually treated symptomatically. However, sedative/hypnotic misuse is associated with complications in this population, especially in the elderly. Such complications include dizziness, falls and over-sedation. Read More

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December 2018
1 Read

Appendix to "A Dissertation on the Effects of Malaria, and Other Malign Atmospherical Influences, in the Production of Febrile Diseases of Various Types and Degrees of Intensity."

Authors:
Andrew Blake

Lond Med Phys J 1833 Jan;14(79):15-19

Physician to the General Lunatic Asylum near Nottingham; late of his Majesty's 7th Regiment of Dragoon Guards, and author of "an Essay on Delirium Tremens," &c.

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January 1833

Remarks on the History and Treatment of Delirium Tremens.

Authors:
John Ware

Lond Med Phys J 1832 Mar;12(69):197-207

Fellow of the Massachusetts Medical Society.

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Remarks on the History and Treatment of Delirium Tremens.

Authors:
John Ware

Lond Med Phys J 1832 Apr;12(70):280-291

Fellow of the Massachusetts Medical Society.

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Remarks on the History and Treatment of Delirium Tremens.

Authors:
John Ware

Lond Med Phys J 1832 Feb;12(68):98-109

Fellow of the Massachusetts Medical Society.

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February 1832

Observations on a Peculiar Kind of Traumatic Delirium.

Authors:
M Helis

Lond Med Phys J 1830 Apr;8(46):287-291

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Observations on Delirium Tremens.

Authors:
John Smith

Lond Med Phys J 1829 Jan;6(31):9-21

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January 1829

On Delirium Ebriositatis.

Authors:
And Blake

Lond Med Phys J 1823 Nov;50(297):355-364

Surgeon, 5th Regiment.

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November 1823

Mr. Perry's .

Med Phys J 1814 Jan;31(179):40-42

Member of the Royal College of Surgeons in London. Bristol.

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January 1814

Dr. M'Whirter's Case of Delirium.

Authors:
T M'Whirter

Med Phys J 1807 Aug;18(102):152-155

Physician to the Newcastle Dispensary. Newcastle upon Tyne.

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Dr. Shapter, on a Case of Delirium.

Authors:
W R Shapter

Med Phys J 1800 Mar;3(13):238-240

Inspector of Hospitals.

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Neopterin and mini-mental state examination scores, two independent risk factors for postoperative delirium in elderly patients with open abdominal surgery.

J Cancer Res Ther 2018 Oct-Dec;14(6):1234-1238

Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China.

Background: Postoperative delirium is described as one of the most common complications for elderly patients with unknown pathophysiological pathways. In this present study, we analyzed the clinical and biochemical parameters in elderly patients with or without a delirium after open abdominal surgery to investigate the possible predicative factors for a delirium.

Materials And Methods: Patients aged ≥60 years scheduled to undergo elective gastrointestinal tumor resection via laparotomy from July 2012 to June 2015 were enrolled in this study. Read More

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November 2018
3 Reads

[Erratum to: Delirium in intensive care patients. A multiprofessional challenge].

Anaesthesist 2018 Nov 28. Epub 2018 Nov 28.

Klinik für Anästhesiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland.

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November 2018

Nurses' Recognition of Hospitalized Older Patients With Delirium and Cognitive Impairment Using the Delirium Observation Screening Scale: A Prospective Comparison Study.

J Gerontol Nurs 2018 Dec;44(12):35-43

The aim of the current study was to report findings about delirium detection when ward nurses screened for delirium in patients with cognitive impairment using the Delirium Observation Screening Scale (DOSS) in comparison to the Confusion Assessment Method (CAM). A secondary analysis was performed of research data collected in 2010 at a Swiss tertiary university hospital. During the first 5 days after admission, patients 70 and older with cognitive impairment were screened for delirium using the DOSS. Read More

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December 2018

Prolonged coma resulting from massive levothyroxine overdose and the utility of N-terminal prohormone brain natriuretic peptide (NT-proBNP).

Clin Toxicol (Phila) 2018 Nov 28:1-3. Epub 2018 Nov 28.

a Monash Clinical Toxicology Unit, Emergency Medicine Service, Monash Health , Melbourne , VIC , Australia.

Introduction: Levothyroxine overdose rarely results in systemic toxicity. We report a case of intentional levothyroxine overdose with a delayed onset coma and delirium lasting two weeks.

Case Summary: A 72-year-old female ingested 12 mg levothyroxine. Read More

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November 2018

Delirium in older emergency department patients.

Authors:
Debra Eagles

CJEM 2018 Nov;20(6):811-812

*Department of Emergency Medicine, University of Ottawa,Ottawa,ON.

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November 2018

Interventions for preventing intensive care unit delirium in adults.

Cochrane Database Syst Rev 2018 Nov 23;11:CD009783. Epub 2018 Nov 23.

The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark, 2100.

Background: Delirium is defined as a disturbance in attention, awareness and cognition with reduced ability to direct, focus, sustain and shift attention, and reduced orientation to the environment. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium. It can profoundly affect both them and their families because it is associated with increased mortality, longer duration of mechanical ventilation, longer hospital and ICU stay and long-term cognitive impairment. Read More

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November 2018
4 Reads

Relation Between Delirium and Anticholinergic Drug Burden in a Cohort of Hospitalized Older Patients: An Observational Study.

Drugs Aging 2018 Nov 27. Epub 2018 Nov 27.

School of Medicine and Surgery, University Milano-Bicocca, Milano, Italy.

Background: Delirium is a neuropsychiatric syndrome which occurs on average in one out of five hospitalized older patients. It is associated with a number of negative outcomes, including worsening of cognitive and functional status, increasing the burden on patients and caregivers, and elevated mortality. Medications with anticholinergic effect have been associated with the clinical severity of delirium symptoms in older medical inpatients, but this association is still debated. Read More

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November 2018

Drug-drug interactions in patients with acute coronary syndrome across phases of treatment.

Intern Emerg Med 2018 Nov 27. Epub 2018 Nov 27.

Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, Kragujevac, 34000, Serbia.

The objective of this study is to evaluate potential drug-drug interactions (pDDIs) and risk factors for pDDIs in three phases of an acute coronary syndrome (ACS) treatment: from the point of first medical contact to the coronary angiography (first phase), after coronary angiography to the last day of hospitalization (second phase), and at discharge from hospital (third phase). This retrospective observational cohort clinical study was conducted at the Clinic for Cardiology of the Clinical Centre Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Micromedex interaction checker was used to detect pDDIs. Read More

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November 2018
3 Reads

Detecting delirium in elderly medical emergency patients: validation and subsequent modification of the German Nursing Delirium Screening Scale.

Intern Emerg Med 2018 Nov 27. Epub 2018 Nov 27.

Department of Emergency Medicine, University Hospital of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Detecting delirium in elderly emergency patients is critical to their outcome. The Nursing Delirium Screening Scale (Nu-DESC) is a short, feasible instrument that allows nurses to systematically screen for delirium. This is the first study to validate the Nu-DESC in a German emergency department (ED). Read More

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November 2018

Demographics, Clinical Characteristics, and Therapeutic Approaches among Older Adults Referred to Mobile Psychiatric Crisis Intervention Teams: A Retrospective Study.

Dement Geriatr Cogn Dis Extra 2018 Sep-Dec;8(3):402-413. Epub 2018 Oct 25.

Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital, Prilly / Prangins, Switzerland.

Background / Aims: The advent of mobile old age psychiatry intervention teams supports policies maintaining older adults in their habitual living environments, even those who are very old and suffering from acute cognitive and psychiatric impairments. Analyzing sociodemographic data, clinical and health characteristics, reasons for crisis-oriented psychiatric consultations, and other therapeutic suggestions for supporting home- or nursing home-dwelling older adult patients suffering from an onset of a psychiatric crisis.

Methods: Reviews of the medical records and discharge letters of home- or nursing home-dwelling older adults who had undergone a consultation with the Lausanne region's Mobile Old Age Psychiatry Teams (MOAPTs), between May 2016 and December 2017. Read More

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October 2018
1 Read

Insight and Dissociation in Lucid Dreaming and Psychosis.

Front Psychol 2018 12;9:2164. Epub 2018 Nov 12.

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

Dreams and psychosis share several important features regarding symptoms and underlying neurobiology, which is helpful in constructing a testable model of, for example, schizophrenia and delirium. The purpose of the present communication is to discuss two major concepts in dreaming and psychosis that have received much attention in the recent literature: insight and dissociation. Both phenomena are considered functions of higher order consciousness because they involve metacognition in the form of reflective thought and attempted control of negative emotional impact. Read More

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November 2018
1 Read

Does the melatonin receptor 1B gene polymorphism have a role in postoperative delirium?

PLoS One 2018 27;13(11):e0207941. Epub 2018 Nov 27.

Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.

Introduction: Patients undergoing cardiac surgery are at high risk for postoperative delirium, which is associated with longer hospital and intensive care lengths of stays, increased morbidity and mortality. Because sleep disturbances are common in delirium, melatonin has been an area of interest in the treatment of delirium. The rs10830963 single nucleotide polymorphism of the melatonin receptor 1B gene can cause pathological dysfunction of this receptor and is associated with delayed morning offset of melatonin. Read More

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November 2018
1 Read