18,136 results match your criteria Delirium


Critical care guidelines on pain, agitation and delirium management: Which one to use? A systematic literature search and quality appraisal with AGREE II.

J Crit Care 2020 May 29;59:124-129. Epub 2020 May 29.

Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address:

Background: Clinical practice guidelines (CPGs) facilitate the provision of standardized, high-quality intensive care medicine. For the management of pain, agitation and delirium, several coexisting CPGs have been published. This study aims at the appraisal of CPGs on pain, agitation and delirium management in the intensive care unit to (a) identify high quality guidelines appropriate for clinical use and (b) identify potential areas for future improvement. Read More

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http://dx.doi.org/10.1016/j.jcrc.2020.05.011DOI Listing

Design of a Randomized Placebo Controlled Trial of High Dose Intravenous Thiamine for the Prevention of Delirium in Allogeneic Hematopoietic Stem Cell Transplantation.

Contemp Clin Trials 2020 Jun 30:106076. Epub 2020 Jun 30.

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: Delirium is a highly prevalent and preventable neuropsychiatric condition with major health consequences. Thiamine deficiency is a well-established cause of delirium in those with chronic, severe alcoholism, but there remains an underappreciation of its significance in non-alcoholic populations, including patients with cancer. Treatment of suspected thiamine-related mental status changes with high dose intravenous (IV) thiamine has preliminary evidence for improving a variety of cognitive symptoms in oncology inpatient settings but has never been studied for the prevention of delirium in any population. Read More

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http://dx.doi.org/10.1016/j.cct.2020.106076DOI Listing

The Acutely Failing Heart Plus Failing Brain Equals Double Trouble: Clinical Significance of Intensive Care Unit Delirium in Patients With Heart Failure.

Can J Cardiol 2020 Mar 30. Epub 2020 Mar 30.

Department of Surgery, Max Rady College of Medicine, University of Manitoba, xxx, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada.

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http://dx.doi.org/10.1016/j.cjca.2020.03.031DOI Listing

Development and validation of an inflammatory-frailty index for kidney transplantation.

J Gerontol A Biol Sci Med Sci 2020 Jul 3. Epub 2020 Jul 3.

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Background: Physical frailty phenotype (PFP) is characterized by decreased physiologic reserve to stressors and associated with poor outcomes, such as delirium and mortality, that may result from post-kidney transplant (KT) inflammation. Despite a hypothesized underlying pro-inflammatory state, conventional measures of frailty typically do not incorporate inflammatory biomarkers directly. Among KT candidates and recipients, we evaluated the inclusion of inflammatory biomarkers with traditional PFP components. Read More

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http://dx.doi.org/10.1093/gerona/glaa167DOI Listing

GABA-B Receptor Encephalitis Triggered by Enterovirus Encephalitis in a Patient With Small Cell Lung Cancer: A Case Report.

Neurologist 2020 Jul;25(4):106-108

Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Introduction: Encephalitis with gamma-aminobutyric acid (GABA)-B receptor antibodies (GABA-B receptor encephalitis) is known to have underlying neoplastic condition in half of the cases; however, there could be an additional event that could work as a trigger factor. Here, we report a patient with GABA-B receptor encephalitis associated with small cell lung cancer, which was probably triggered by enterovirus encephalitis.

Case Report: A 53-year-old man was admitted for a seizure, following fever and headache for 3 days. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000283DOI Listing

Peri-operative management of frailty in the orthopedic patient.

J Orthop 2020 Nov-Dec;22:304-307. Epub 2020 Jun 11.

UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA.

The purpose of this investigation was to summarize current research on diagnosis, outcomes, and management of frail patients undergoing orthopedic surgery. Because frail patients are at increased risk of negative post-operative outcomes including increased 30-day mortality and post-operative complications including infections and delirium, such a review is timely. Strategies including supervised exercise training programs before surgery, early identification of frailty, prophylactic antibiotics, regular drug chart review, regular monitoring of electrolytes, and other strategies to prevent post-operative delirium are helpful in the management of frail orthopedic patients. Read More

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http://dx.doi.org/10.1016/j.jor.2020.05.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322091PMC

Prognostic Value of Delirium in Patients With Acute Heart Failure in the Intensive Care Unit.

Can J Cardiol 2020 Jan 16. Epub 2020 Jan 16.

Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Background: Delirium is a common adverse event observed in patients admitted to the intensive care unit (ICU). However, the prognostic value of delirium and its determinants have not been thoroughly investigated in patients with acute heart failure (AHF).

Methods: We investigated 408 consecutive patients with AHF admitted to the ICU. Read More

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http://dx.doi.org/10.1016/j.cjca.2020.01.006DOI Listing
January 2020

Should we still monitor QTc duration in frail older patients on low-dose haloperidol? A prospective observational cohort study.

Age Ageing 2020 Jul 2. Epub 2020 Jul 2.

Cardiology Department, Maastricht University Medical Centre, Maastricht 6229 HX, The Netherlands.

Background: Haloperidol at high dosage is associated with QTc prolongation and polymorphic ventricular arrhythmia but the effects of low-dose haloperidol remain unknown.

Objective: To evaluate the effects of low-dose haloperidol on QTc-duration in frail hospitalized elderly patients with delirium.

Methods: A prospective observational study including hospitalized patients aged ≥70 years with Groningen Frailty Index-score > 3. Read More

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http://dx.doi.org/10.1093/ageing/afaa066DOI Listing

Managing delirium in terminally ill patients: perspective of palliative care nurse specialists.

Br J Community Nurs 2020 Jul;25(7):346-352

Research lead, Marie Curie Hospice Edinburgh and Honorary Research Fellow, University of Edinburgh.

Delirium occurs frequently at end of life. Palliative care clinical nurse specialists (CNSs) are involved in community palliative care provision. Many patients prefer being cared for at home, yet managing delirium in this setting presents unique challenges, potentially resulting in emergency hospital or hospice admission. Read More

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http://dx.doi.org/10.12968/bjcn.2020.25.7.346DOI Listing

[Tasered: medical consequences of the use of electric stun guns].

Ned Tijdschr Geneeskd 2020 Jun 11;164. Epub 2020 Jun 11.

Haaglanden Medisch Centrum, afd. Cardiologie, Den Haag.

The Electronic Control Device (ECD) will be used by the primary police force in the Netherlands. Hence medical personnel will be confronted with persons that have received ECD shocks more often. In light of these developments, it is important that care providers are aware of potential medical consequences resulting from the use of electric stun guns. Read More

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Cefepime is Associated with Acute Encephalopathy in Critically Ill Patients: A Retrospective Case-Control Study.

Neurocrit Care 2020 Jul 1. Epub 2020 Jul 1.

Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, 200 First St. SW - Mayo W8B, Rochester, MN, 55905, USA.

Background: Acute encephalopathy (AE) is a common complication of critical illness and is associated with increased short and long-term mortality. In this study, we evaluated the role of cefepime in causing AE.

Methods: Retrospective case-control study involving consecutive patients enrolled in the intensive care units (ICUs) of Mayo Clinic Rochester, MN between July 1, 2004 and December 31, 2015. Read More

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http://dx.doi.org/10.1007/s12028-020-01035-wDOI Listing

Incidence and risk factors associated with postoperative delirium following primary elective total hip arthroplasty: a retrospective nationwide inpatient sample database study.

BMC Psychiatry 2020 Jul 1;20(1):343. Epub 2020 Jul 1.

Department of Orthopaedic Surgery, Division of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.

Background: Postoperative delirium is a common complication following major surgeries, leading to a variety of adverse effects. However, there is a paucity of literatures studying the incidence and risk factors associated with delirium after primary elective total hip arthroplasty (THA) using a large-scale national database.

Methods: A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2009 to 2014. Read More

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http://dx.doi.org/10.1186/s12888-020-02742-6DOI Listing

The affinity and selectivity of α-adrenoceptor antagonists, antidepressants, and antipsychotics for the human α1A, α1B, and α1D-adrenoceptors.

Pharmacol Res Perspect 2020 Aug;8(4):e00602

Cell Signalling Research Group, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, C Floor Medical School, Queen's Medical Centre, University of Nottingham, Nottingham, UK.

α1-adrenoceptor antagonists are widely used for hypertension (eg, doxazosin) and benign prostatic hypertrophy (BPH, eg, tamsulosin). Some antidepressants and antipsychotics have been reported to have α1 affinity. This study examined 101 clinical drugs and laboratory compounds to build a comprehensive understanding of α1-adrenoceptor subtype affinity and selectivity. Read More

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http://dx.doi.org/10.1002/prp2.602DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327383PMC

Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization.

Am J Crit Care 2020 Jul;29(4):311-317

Babar Khan is an associate professor, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine; and a research scientist, Indiana University Center for Aging Research, Regenstrief Institute.

Background: Critical care patients with delirium are at an increased risk of functional decline and mortality long term.

Objective: To determine the relationship between delirium severity in the intensive care unit and mortality and acute health care utilization within 2 years after hospital discharge.

Methods: A secondary data analysis of the Pharmacological Management of Delirium and Deprescribe randomized controlled trials. Read More

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http://dx.doi.org/10.4037/ajcc2020498DOI Listing

Risk Prediction for Adverse Outcomes for Frail Older Persons with Complex Healthcare and Social Care Needs Admitted to a Community Virtual Ward Model.

Clin Interv Aging 2020 22;15:915-926. Epub 2020 Jun 22.

School of Nursing and Midwifery, Royal College of Surgeons Ireland, Dublin, Ireland.

Purpose: Population ageing is challenging healthcare systems with limited resources, necessitating the development of new care models to address the needs of older, frail community-dwellers. Community Virtual Wards (CVW) reduce adverse events in these patients. We examined the effect of an established CVW on pre-defined health trajectories (between "stable", "deteriorating", and "unstable" states) and characteristics that increased the likelihood of adverse healthcare outcomes (hospitalization, institutionalization and death). Read More

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http://dx.doi.org/10.2147/CIA.S236895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320026PMC

Comparative efficacy of Neuraxial and general anesthesia for hip fracture surgery: a meta-analysis of randomized clinical trials.

BMC Anesthesiol 2020 Jun 30;20(1):162. Epub 2020 Jun 30.

Department of Anesthesiology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, China.

Background: The choice of anesthesia technique remains debatable in patients undergoing surgical repair of hip fracture. This meta-analysis was performed to compare the effect of neuraxial (epidural/spinal) versus general anesthesia on perioperative outcomes in patients undergoing hip fracture surgery.

Methods: Medline, Cochrane Library, Science-Direct, and EMBASE databases were searched to identify eligible studies focused on the comparison between neuraxial and general anesthesia in hip fracture patients between January 2000 and May 2019. Read More

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http://dx.doi.org/10.1186/s12871-020-01074-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325684PMC

Wireless Monitoring Through Wearable Devices in the ICU: Are We Close?

Stud Health Technol Inform 2020 Jun;272:175-178

Second Critical Care Department, General University Hospital Attikon, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Patients admitted to the ICU present life-threatening conditions requiring support from multidisciplinary specialists and continuous monitoring of vital signs and other parameters by a state-of-the-art medical technology. Wireless monitoring through wearable devices could be useful for hospitalized patients, particularly those who are unstable or at higher risk for serious complications such as critically ill patients. This review aims at summarizing current evidence regarding the use of wireless monitoring in the ICU setting. Read More

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http://dx.doi.org/10.3233/SHTI200522DOI Listing

Development of disturbance of consciousness is associated with increased severity in acute pancreatitis.

Pancreatology 2020 May 18. Epub 2020 May 18.

Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary; School of Clinical Medicine, University of Szeged, Szeged, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Hungary. Electronic address:

Background: Disturbance of consciousness (DOC) may develop in acute pancreatitis (AP). In clinical practice, it is known that DOC may worsen the patient's condition, but we have no exact data on how DOC affects the outcome of AP.

Methods: From the Hungarian Pancreatic Study Groups' AP registry, 1220 prospectively collected cases were analyzed, which contained exact data on DOC, included patients with confusion, delirium, convulsion, and alcohol withdrawal, answering a post hoc defined research question. Read More

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http://dx.doi.org/10.1016/j.pan.2020.05.009DOI Listing

Incidence and risk factors of in-hospital prosthesis-related complications following total hip arthroplasty: a retrospective Nationwide Inpatient Sample database study.

Int Orthop 2020 Jun 27. Epub 2020 Jun 27.

Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.

Purpose: The occurrence of prosthesis-related complications (PRCs) after total hip arthroplasty (THA) is devastating, commonly meaning implant failure and revision surgery. The purpose was to examine the incidence and risk factors of in-hospital PRCs following THA using a large-scale national database.

Methods: A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2005 to 2014. Read More

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http://dx.doi.org/10.1007/s00264-020-04682-yDOI Listing

The Another Side of COVID-19 in Alzheimer's Disease Patients: Drug-Drug Interactions.

Int J Clin Pract 2020 Jun 27:e13596. Epub 2020 Jun 27.

Hacettepe University, Faculty of Pharmacy, Department of Clinical Pharmacy, Ankara, Turkey.

Coronavirus Disease 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major public health problem. The elderly people are the most affected population by the COVID-19 outbreak in terms of mortality and morbidity. Delirium caused by hypoxia, a prominent clinical feature of COVID-19, may increase the need for treatment of Alzheimer's disease (AD) patients (1). Read More

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http://dx.doi.org/10.1111/ijcp.13596DOI Listing

Downregulation of synapse-associated protein expression and loss of homeostatic microglial control in cerebrospinal fluid of infectious patients with delirium and patients with Alzheimer's disease.

Brain Behav Immun 2020 Jun 24. Epub 2020 Jun 24.

Radboudumc, Radboud Institute for Molecular Life Sciences, Department of Intensive Care Medicine, Nijmegen, The Netherlands; Radboudumc, Radboud Center for Infectious Diseases, Nijmegen, The Netherlands. Electronic address:

Delirium is a complex and multifactorial condition associated with long-term cognitive decline. Due to the strong links between systemic inflammation, delirium and dementia we hypothesized that responses within the brain in patients who develop delirium could show biochemical overlap with patients with Alzheimer's disease (AD). In this observational study we analyzed protein expression signatures in cerebrospinal fluid (CSF) from 15 patients with infectious delirium and compared these to 29 patients with AD, 30 infectious patients without delirium and 15 non-infectious controls free of neurological disease. Read More

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http://dx.doi.org/10.1016/j.bbi.2020.06.027DOI Listing

The Agents Intervening against Delirium in the Intensive Care Unit-Trial (AID-ICU trial):- a detailed statistical analysis plan.

Acta Anaesthesiol Scand 2020 Jun 27. Epub 2020 Jun 27.

Centre for Research in Intensive Care (CRIC), Copenhagen, Denmark.

Background: The AID-ICU trial aims to assess the benefits and harms of haloperidol for the treatment of delirium in acutely admitted, adult intensive care unit (ICU) patients. This paper describes the detailed statistical analysis plan for the primary publication of results from the AID-ICU trial.

Methods: The AID-ICU trial is a investigator-initiated, pragmatic, international, multicentre, randomised, blinded, parallel-group trial allocating 1000 adult ICU patients with manifest delirium 1:1 to haloperidol or placebo. Read More

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http://dx.doi.org/10.1111/aas.13661DOI Listing

Comparison of Esophagectomy outcomes between a National Center, a National Audit Collaborative, and an International database using the Esophageal Complications Consensus Group (ECCG) standardized definitions.

Dis Esophagus 2020 Jun 27. Epub 2020 Jun 27.

Virginia Mason Medical Center, Seattle, WA, USA.

The ECCG developed a standardized platform for reporting operative complications, with consensus definitions. The Dutch Upper Gastrointestinal Cancer Audit (DUCA) published a national comparison against these benchmarks. This study compares ECCG data from the Irish National Center (INC) with both published benchmark studies. Read More

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http://dx.doi.org/10.1093/dote/doaa060DOI Listing

COVID-19-Associated Hyperactive Intensive Care Unit Delirium With Proposed Pathophysiology and Treatment: A Case Report.

Psychosomatics 2020 May 19. Epub 2020 May 19.

Department of Medicine - Pulmonary, Allergy & Critical Care Medicine, Stanford University Medical Center, Stanford, CA.

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http://dx.doi.org/10.1016/j.psym.2020.05.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236743PMC

Preventing Delirium in Older Adults in Institutional Long-Term Care.

Authors:
Lisa Whitehead

Am J Nurs 2020 Jul;120(7):25

Lisa Whitehead is professor of nursing research at the Edith Cowan University School of Nursing and Midwifery, Joondalup, Western Australia, and a member of the Cochrane Nursing Care Field.

Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing. Read More

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http://dx.doi.org/10.1097/01.NAJ.0000688192.30216.2aDOI Listing

Epigenetics of neuroinflammation: Immune response, inflammatory response and cholinergic synaptic involvement evidenced by genome-wide DNA methylation analysis of delirious inpatients.

J Psychiatr Res 2020 Jun 6;129:61-65. Epub 2020 Jun 6.

Department of Psychiatry, University of Iowa, Iowa City, IA, USA; Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA; Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA, USA. Electronic address:

Previously our study has shown that the DNA methylation (DNAm) levels at CpG sites in the pro-inflammatory cytokine gene, TNF-alpha, decrease along with aging, suggesting the potential role of DNAm in aging and heightened inflammatory process leading to increased risk for delirium. However, DNAm differences between delirium cases and non-delirium controls have not been investigated directly. Therefore, we examined genome-wide DNAm differences in blood between patients with delirium and controls to identify useful epigenetic biomarkers for delirium. Read More

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http://dx.doi.org/10.1016/j.jpsychires.2020.06.005DOI Listing

Delirium after abrupt discontinuation of clozapnie.

Asian J Psychiatr 2020 Jun 15;53:102235. Epub 2020 Jun 15.

Department of Psychiatry, Rajarshee Chhatrapati Shahu Maharaj Government Medical College, Kolhapur, 416003, India.

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http://dx.doi.org/10.1016/j.ajp.2020.102235DOI Listing

Neurological features of COVID-19 and their treatment: a review.

Drugs Context 2020 11;9. Epub 2020 Jun 11.

Unit of Neurology, San Luca Hospital, Lucca, Italy.

Severe acute respiratory syndrome-correlated new coronavirus (SARS-Cov-2) infection may result in neurological signs and symptoms through different mechanisms. Although direct infection of the central nervous system is uncertain or very rare and the para-infectious complications (e.g. Read More

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http://dx.doi.org/10.7573/dic.2020-5-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295105PMC

[The Early Mobilization Network].

Med Klin Intensivmed Notfmed 2020 Jun 24. Epub 2020 Jun 24.

Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.

Background: Since its foundation in 2011, the German Network for Early Mobilization of mechanically ventilated intensive care patients delivered, among others, more than 90 monthly newsletters, 14 research projects, and 3 national conferences.

Purpose: The aim of this online survey was to evaluate whether members of the Network perceived a professional benefit for themselves and their intensive cate units (ICU).

Methods: An interprofessional online survey of 303 clinicians of the Network in German speaking countries in July 2019 was undertaken. Read More

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http://dx.doi.org/10.1007/s00063-020-00700-4DOI Listing

Metoprolol-Associated Central Nervous System Complications.

Cureus 2020 May 22;12(5):e8236. Epub 2020 May 22.

Internal Medicine, HCA Citrus Memorial Hospital, Inverness, USA.

Metoprolol is a common medication used by the elderly because it is affordable and has proven to decrease mortality in cardiovascular disease. Multiple studies have reported central nervous system (CNS) side effects associated with use of beta-blockers. The risk of beta-blocker CNS side effects is directly associated with the lipophilic property of the drug. Read More

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http://dx.doi.org/10.7759/cureus.8236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306637PMC

Occupational therapist-led mindfulness-based stress reduction for older adults living with subjective cognitive decline or mild cognitive impairment in primary care: a feasibility randomised control trial protocol.

BMJ Open 2020 Jun 23;10(6):e035299. Epub 2020 Jun 23.

Rehabilitation Therapy, Queen's University Faculty of Health Sciences, Kingston, Ontario, Canada.

Introduction: Community-dwelling older adults living with subjective cognitive decline or mild cognitive impairment may experience decreased efficiency in their overall functional performance. This decreased cognitive efficiency may result in anxiety, low mood, perceived stress and decreased emotional well-being and quality-of-life. These psychological symptoms may further exacerbate cognitive decline. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-035299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312340PMC

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis.

Ideggyogy Sz 2020 05;73(05-06):189-197

Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.

Background And Purpose: Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. Read More

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http://dx.doi.org/10.18071/isz.73.0189DOI Listing

Interventions to prevent in-hospital falls in older people with cognitive impairment for further research: a mixed studies review.

J Clin Nurs 2020 Jun 24. Epub 2020 Jun 24.

G01, 2.05c, Griffith University Parklands Drive, Gold Coast, QLD, 4222, Australia.

Background: While advances in falls prevention in the adult population have occurred, the care requirements for older patients with cognitive impairment at risk of falling are less established.

Objectives: The aim of this review was to identify interventions to prevent in-hospital falls in older patients with cognitive impairment for further research and describe the strategies used to implement those interventions.

Design: A seven-stage mixed studies review was used. Read More

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http://dx.doi.org/10.1111/jocn.15383DOI Listing

Evaluating Performance and Interpretability of Machine Learning Methods for Predicting Delirium in Gerontopsychiatric Patients.

Stud Health Technol Inform 2020 Jun;271:121-128

Institute of Medical Informatics, Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.

Delirium is an acute mental disturbance that particularly occurs during hospital stay. Current clinical assessment instruments include the Delirium Observation Screening Scale (DOSS) or the Confusion Assessment Method (CAM). The aim of this work is to analyze the performance of machine learning approaches to detect delirium based on DOSS and CAM information obtained from two geropsychiatric wards in Tyrol. Read More

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http://dx.doi.org/10.3233/SHTI200087DOI Listing

Common neurodegenerative disorders in the perioperative setting: Recommendations for screening from the Society for Perioperative Assessment and Quality Improvement (SPAQI).

Perioper Care Oper Room Manag 2020 Sep 5;20. Epub 2020 Feb 5.

Department of Clinical and Health Psychology, University of Florida, 1225 Center Drive, Gainesville, FL 32603.

Aging is associated with normal and abnormal brain and cognitive changes. Due to the expected increase in older adults requiring surgery, perioperative clinicians will be increasingly encountering patients with neurodegenerative disease. To help perioperative clinicians understand signs of abnormal behaviors that may mark an undiagnosed neurodegenerative disorder and alert additional patient monitoring, The Society for Perioperative Assessment and Quality Improvement (SPAQI) worked with experts in dementia, neuropsychology, geriatric medicine, neurology, and anesthesiology to provide a summary of cognitive and behavioral considerations for patients with common neurodegenerative disorders being evaluated at preoperative centers. Read More

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http://dx.doi.org/10.1016/j.pcorm.2020.100092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311090PMC
September 2020

Epileptic seizures.

Discoveries (Craiova) 2020 Jun 12;8(2):e110. Epub 2020 Jun 12.

CMH Lahore Medical College & Institute of Dentistry, Lahore, Pakistan.

Epilepsy is a condition marked by abnormal neuronal discharges or hyperexcitability of neurons with synchronicity and is recognized as a major public health concern. The pathology is categorized into three subgroups: acquired, idiopathic, and epilepsy of genetic or developmental origin. There are approximately 1000 associated genes and the role of γ-aminobutyric acid (GABA) mediated inhibition, as well as glutamate mediated excitation, forms the basis of pathology. Read More

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http://dx.doi.org/10.15190/d.2020.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305811PMC

Emergence Delirium in Elderly Patients as a Potential Predictor of Subsequent Postoperative Delirium: A Descriptive Correlational Study.

J Perianesth Nurs 2020 Jun 20. Epub 2020 Jun 20.

Nursing Education Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.

Purpose: This study aimed to investigate the incidence of emergence delirium (ED) in elderly patients under general anesthesia and to determine the correlation between ED and delirium at five subsequent postoperative days.

Design: This research is a descriptive correlational study.

Methods: A total of 168 aged patients undergoing elective general anesthesia were recruited from a comprehensive tertiary teaching hospital with 2,400 beds in Southern China from April 2018 to September 2018. Read More

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http://dx.doi.org/10.1016/j.jopan.2019.11.009DOI Listing

Delirium After Withdrawal From Valerian Root: A Case Report.

Psychosomatics 2020 May 22. Epub 2020 May 22.

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

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http://dx.doi.org/10.1016/j.psym.2020.05.003DOI Listing

[Research progress of delirium in intensive care unit].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2020 May;32(5):636-640

Department of Anesthesiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China. Corresponding author: Zhu Bin, Email:

Delirium is an acute brain dysfunction syndrome that is common in adult critical care patients. The pathogenesis of delirium is highly related with neuroinflammation, neurotransmitter imbalance, abnormal stress response, and cerebral ischemia. In intensive care unit (ICU), the occurrence of delirium is accompanied with long-term cognitive impairment in patients. Read More

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http://dx.doi.org/10.3760/cma.j.cn121430-20200204-00164DOI Listing

COVID-19: ICU delirium management during SARS-CoV-2 pandemic-pharmacological considerations.

Crit Care 2020 06 23;24(1):375. Epub 2020 Jun 23.

Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, 833 South Wood Street, RM 164 MC 886, Chicago, IL, 60612-7230, USA.

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http://dx.doi.org/10.1186/s13054-020-03072-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309692PMC

Geriatric Nutritional Risk Index can predict postoperative delirium and hospital length of stay in elderly patients undergoing non-cardiac surgery.

Geriatr Gerontol Int 2020 Jun 22. Epub 2020 Jun 22.

Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China.

Aim: Malnutrition is common in older patients and is associated with adverse outcomes. The Geriatric Nutritional Risk Index (GNRI) has been developed as an objective index to assess nutritional risk in these patients. However, there is limited evidence regarding the association between GNRI and postoperative delirium (POD) as well as length of stay (LOS) in surgical older patients. Read More

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http://dx.doi.org/10.1111/ggi.13963DOI Listing

The Perils of Diagnostic Parsimony.

Acad Emerg Med 2020 Jun 22. Epub 2020 Jun 22.

University of Virginia Medical Center, Department of Medical Toxicology, Charlottesville, Virginia, USA.

Mrs. P. waved at one of our medical students: not so unusual - how often do patients find something familiar or interesting in one of us, a tone of the relatable in our universe of the strange? For Mrs. Read More

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http://dx.doi.org/10.1111/acem.14060DOI Listing

Reducing Delirium in Hospitalized Adults Through a Structured Sleep Promotion Program.

J Nurs Care Qual 2020 Jun 15. Epub 2020 Jun 15.

Abbott Northwestern Hospital, Minneapolis, Minnesota.

Background: Delirium affects approximately 1 in 4 patients during their hospitalization and is associated with numerous complications. Sleep deprivation is a significant risk factor for developing delirium and is a patient dissatisfier.

Problem: An internal assessment revealed that up to 25% of all patients on medical-surgical units had a diagnosis of delirium while in the hospital. Read More

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http://dx.doi.org/10.1097/NCQ.0000000000000499DOI Listing

Delirium and Clarity in Research Regarding Biomarkers for Delirium in ICU Patients: Search for the Starting Point.

Crit Care Med 2020 Jul;48(7):e637-e638

Critical Care Medicine, Dubai Hospital, Dubai, United Arab Emirates Internal Medicine, Dubai Hospital, Dubai, United Arab Emirates.

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http://dx.doi.org/10.1097/CCM.0000000000004321DOI Listing

Diagnosing Delirium in Neurocritically Ill Patients Using New Data.

Crit Care Med 2020 Jul;48(7):e635-e636

Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, and Department of Bioengineering, Vanderbilt University, Nashville, TN Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, Department of Surgery, Neurosurgery and Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, and General Surgery Service, Tennessee Valley VA Healthcare System, Nashville, TN Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, and Geriatric Research Education Clinical Center (VA-GRECC), Tennessee Valley VA Healthcare System, Nashville, TN.

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http://dx.doi.org/10.1097/CCM.0000000000004338DOI Listing

Postoperative Delirium: A Minefield of Markers and Mediators.

Anesthesiology 2020 Jun 17. Epub 2020 Jun 17.

From the Department of Anaesthesia and Pain Medicine, Waikato Clinical School, University of Auckland, Hamilton, New Zealand.

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http://dx.doi.org/10.1097/ALN.0000000000003383DOI Listing

Disseminated bacillus Calmette-Guérin (BCG): a cause of delirium in an older adult.

J R Coll Physicians Edinb 2020 Jun;50(2):152-155

Academic Unit for Ageing and Stroke Research University of Leeds, Bradford Teaching Hospitals NHS Foundation Trust Bradford BD9 6RJ, UK, Email:

Intra-vesical Bacillus Calmette-Guérin (BCG) immunotherapy is an effective treatment for high-risk bladder cancer. Less well known is that fewer than 1% of patients receiving BCG treatment can develop disseminated BCG. The reaction can range from a mild flu-like illness to a systemic disorder with a fulminant course which in the most severe cases can lead to death. Read More

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http://dx.doi.org/10.4997/JRCPE.2020.215DOI Listing

Impact of Early Reinitiation of Neuropsychiatric Medications on Agitation and Delirium in the Intensive Care Unit: A Retrospective Study.

Ann Pharmacother 2020 Jun 21:1060028020935589. Epub 2020 Jun 21.

Cleveland Clinic Akron General, Akron, OH, USA.

Approximately 17% of intensive care unit (ICU) patients are prescribed at least 1 home neuropsychiatric medication (NPM). When abruptly discontinued, withdrawal symptoms may occur manifesting as agitation or delirium in the ICU setting. To evaluate the impact of early reinitiation of NPMs. Read More

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http://dx.doi.org/10.1177/1060028020935589DOI Listing

Changing dynamics of psychoneuroimmunology during the COVID-19 pandemic.

Brain Behav Immun Health 2020 May 15;5:100096. Epub 2020 Jun 15.

Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.

The Coronavirus Disease-2019 (COVID-19) pandemic has led to a global health care crisis. Emerging research suggest an unanticipated impact of COVID-19 on mental and/or psychological health of both the general community and affected individuals. The fear of the COVID-19 epidemic and the consequent lockdown and economic crisis has led to globally increased psychological distress. Read More

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http://dx.doi.org/10.1016/j.bbih.2020.100096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295528PMC