20,215 results match your criteria Delirium


Behavioral changes after hospital discharge in preschool children experiencing emergence delirium after general anesthesia: a prospective observational study.

Paediatr Anaesth 2021 Jul 26. Epub 2021 Jul 26.

Department of Anesthesiology and Pain Medicine, Hanyang University Medical Center, College of Medicine, Hanyang University, Seoul, Republic of Korea.

Background: Emergence delirium is well known as early postoperative behavioral change after general anesthesia. However, it is unclear whether children with emergence delirium have negative behavioral changes after hospital discharge.

Aim: This observational study investigated the association between emergence delirium and post-hospital behavioral changes. Read More

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"Cerebral venous sinus thrombosis sequel of COVID Encephalitis; a rare presentation".

Authors:
Iqra Athar

Brain Hemorrhages 2021 Jul 16. Epub 2021 Jul 16.

Department of Neurology, PIMS Hospital, Islamabad, Pakistan.

The SARS Covid-19 pneumonia became a pandemic in 2019 affecting millions worldwide and carried a significant high mortality rate. The common presentation of this novel virus is upper and lower respiratory tract infection. However, its popularity as neuropathogen has increased dramatically. Read More

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Determining preoperative brain MRI features and occurrence of postoperative delirium.

J Psychosom Res 2021 Sep 6;148:110568. Epub 2021 Jul 6.

Department of Intensive Care, University Medical Center Utrecht, the Netherlands; Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium.

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September 2021

Evaluation of the effectiveness of delirium prevention care protocol for the patients with hip fracture: A randomised controlled study.

J Clin Nurs 2021 Jul 23. Epub 2021 Jul 23.

Geriatrics Department, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

Aims And Objectives: This study aimed to investigate the effectiveness of a delirium prevention care protocol on pain, functional status, sleep quality and delirium prevention in patients with hip fractures.

Background: The development of delirium following hip fracture is common among older patients. According to the National Institute for Health and Care Excellence, 30% of delirium cases are preventable. Read More

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Circulating MicroRNAs and Novel Proteins as Potential Biomarkers of Neurological Complications after Heart Bypass Surgery.

J Clin Med 2021 Jul 13;10(14). Epub 2021 Jul 13.

Department of Clinical Neuropsychology, Collegium Medicum, Nicolaus Copernicus University, 87-100 Toruń, Poland.

Postoperative recovery can be impaired by many conditions, some of which are difficult to diagnose clinically. These include type 2 neurological complications such as hypoactive subtype of postoperative delirium (PD) and early postoperative cognitive dysfunction (ePOCD). Hope for their timely detection may lie with novel biomarkers. Read More

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The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians.

J Clin Med 2021 Jul 7;10(14). Epub 2021 Jul 7.

Working Group on the Development of Geriatric Medicine in Greece of the Hellenic Society for the Study and Research of Aging, 15342 Athens, Greece.

Geriatric Medicine (GM) holds a crucial role in promoting health and managing the complex medical, cognitive, social, and psychological issues of older people. However, basic principles of GM, essential for optimizing the care of older people, are commonly unknown or undermined, especially in countries where GM is still under development. This narrative review aims at providing insights into the role of GM to non-geriatrician readers and summarizing the main aspects of the added value of a geriatric approach across the spectrum of healthcare. Read More

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Stability of Dexmedetomidine in Polyvinyl Chloride Bags Containing 0.9% Sodium Chloride Intended for Subcutaneous Infusions.

Int J Pharm Compd 2021 Jul-Aug;25(4):330-335

Department of Pharmacy, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Dexmedetomidine is a sedative medication with co-analgesic effects that has been used primarily in critical care and anesthesia as a continuous intravenous infusion. Its utility in the treatment of refractory agitated delirium is being investigated in other settings including palliative care, but continuous intravenous infusions are not always feasible during end-of-life care. Subcutaneous infusions are more commonly used in this setting, but smaller volumes and higher concentrations are typically required. Read More

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Surgical Trainees and The Geriatric Patient: A Scoping Review.

J Surg Educ 2021 Jul 19. Epub 2021 Jul 19.

Division of Trauma, Critical Care, and Acute Care Surgery, OHSU, Portland, Oregon. Electronic address:

Objective: There is an increasing emphasis on surgical trainees learning how to appropriately provide care for the geriatric patient. We hypothesized that little published formal curriculum on the topic exists. We sought to perform a scoping review to test this hypothesis. Read More

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Wernicke encephalopathy in a lung cancer patient receiving home medical care.

Palliat Support Care 2021 Aug;19(4):501-503

Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan.

Objective: Cancer patients often want to spend their final days at home, and it is essential that general practitioners have knowledge of and technical skills related to cancer medicine and symptom relief. Recent clinical studies have revealed that Wernicke encephalopathy (WE) is quite common in cancer patients. However, there have been no reports to date on WE in cancer patients undergoing home medical care. Read More

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Risk Factors for Mortality After Uncemented Bipolar Hemiarthroplasty for Geriatric Displaced Femoral Neck Fracture.

Orthopedics 2021 Jul-Aug;44(4):e570-e576. Epub 2021 Jul 1.

Uncemented bipolar hemiarthroplasty (UBHA) has been widely used to treat geriatric displaced femoral neck fracture (GDFNF), which results in a high 30-day mortality rate among the elderly. To date, few studies have focused on the risk factors for mortality after UBHA for GDFNF. In this retrospective study, elderly patients (age ≥70 years) who underwent UBHA for GDFNF were studied in order to provide helpful insight into the risk factors for mortality postoperatively. Read More

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Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow-up.

Brain Behav 2021 Jul 21. Epub 2021 Jul 21.

Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Background: Visual hallucinations are common in patients with Parkinson's disease and represent probably the major independent predictor for cognitive deterioration and nursing home placement.

Objective: To investigate if treatment of minor visual hallucinations in Parkinson's disease with rivastigmine delays the progression to psychosis.

Methods: A multicenter, randomized, double-blind, placebo-controlled trial was conducted which aimed to recruit 168 patients with Parkinson's disease reporting minor visual hallucinations 4 weeks before it. Read More

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Frailty predicts failure to discharge patients home from a subacute-care unit: a 3-year Italian experience.

Aging Clin Exp Res 2021 Jul 21. Epub 2021 Jul 21.

School of Medicine and Surgery, University of Milano-Bicocca, U8 Building, Floor 4, Lab 4045 Via Cadore, 48, 20900, Monza, Italy.

Background: The primary purpose of Subacute Care Units (SCU) is to decongest acute hospital wards and facilitate the return of older patients to home.

Aims: We analyzed the clinical characteristics and outcomes of patients admitted to an Italian SCU, and we explored factors associated with discharge to locations other than home (outcome).

Methods: This retrospective observational cohort study was conducted at a medium-sized suburban hospital, enrolling all patients consecutively admitted to one SCU from October 2017 to February 2020. Read More

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Sepsis-Associated Encephalopathy and Blood-Brain Barrier Dysfunction.

Inflammation 2021 Jul 21. Epub 2021 Jul 21.

Division of Cardiology, Department of Medicine, Emory University, 101 Woodruff Circle, WMB 308, Atlanta, GA, 30322, USA.

Sepsis is a life-threatening clinical condition caused by a dysregulated host response to infection. Sepsis-associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis, which is associated with increased morbidity and mortality. SAE clinical presentation may range from mild confusion and delirium to severe cognitive impairment and deep coma. Read More

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Pimavanserin in Dementia-Related Psychosis.

N Engl J Med 2021 07;385(4):372-373

From the Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, and Delirium Services, Mount Sinai System of Hospitals, New York.

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Post-flight confusion: does flying affect the brain?

BJPsych Int 2020 Aug;17(3):62-65

PhD, FRCS, FRCP, FRGS, Consultant Vascular and Renal Transplant Surgeon, Director of Research and Development, University Hospitals Coventry and Warwick NHS Trust, UK.

This paper describes a condition termed post-flight confusion using anecdotal and clinical observations. It reviews research from the fields of aviation and altitude medicine and how this could apply to some physiological changes that happen during commercial flights. The collection of symptoms observed is similar to those of delirium. Read More

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Clinical Management of the Alcohol Withdrawal Syndrome.

Authors:
Ed Day Chris Daly

Addiction 2021 Jul 21. Epub 2021 Jul 21.

Addiction Psychiatry, Chapman Barker Unit, Bury New Road, Prestwich, Manchester, M25 3BL.

Up to half of individuals with a history of long-term, heavy alcohol consumption will experience the alcohol withdrawal syndrome (AWS) when consumption is significantly decreased or stopped. In its most severe form AWS can be life-threatening. Medically assisted withdrawal (MAW) often forms the first part of a treatment pathway. Read More

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Mortality risk factors in a Spanish cohort of oldest-old patients hospitalized with COVID-19 in an acute geriatric unit: the OCTA-COVID study.

Eur Geriatr Med 2021 Jul 21. Epub 2021 Jul 21.

Servicio de Geriatría, Hospital Central de la Cruz Roja San José y Santa Adela, C/Reina Victoria, 24, 28003, Madrid, Spain.

Purpose: To determine predictors of in-hospital mortality related to COVID-19 in oldest-old patients.

Design: Single-center observational study.

Setting And Participants: Patients ≥ 75 years admitted to an Acute Geriatric Unit with COVID-19. Read More

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Neurological manifestations in patients with symptomatic COVID-19 admitted to the Bafoussam Regional Hospital, Cameroon.

Pan Afr Med J 2021 5;38:326. Epub 2021 Apr 5.

Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada.

Introduction: although the main manifestations of COVID-19 are respiratory, several neurological symptoms and complications have also been reported. The pandemic seems to have some epidemiological specificities in sub-Saharan Africa, and this may be reflected in the type and frequency of neurological symptoms. This study aimed to report neurological manifestations associated with symptomatic COVID-19 in a sub-Saharan African setting. Read More

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Clinical Efficacy of Hybrid Surgery for Stanford Type A Aortic Dissection.

Risk Manag Healthc Policy 2021 14;14:3013-3023. Epub 2021 Jul 14.

Department of Cardiac Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.

Introduction: To evaluate the clinical efficacy of hybrid surgery for Stanford type A aortic dissection.

Methods: Twenty-two patients with Stanford type A aortic dissection were selected. All patients had completed or undergone hybrid surgery, including extracorporeal circulation, treatment of proximal anastomosis of ascending aorta and the distal anastomosis of the ascending aorta, management of the branch vessels on the arch, aortic endovascular repair. Read More

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Sedation strategy and ICU delirium: a multicentre, population-based propensity score-matched cohort study.

BMJ Open 2021 07 20;11(7):e045087. Epub 2021 Jul 20.

Department of Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

Objectives: We examined the relationship between dominant sedation strategy, risk of delirium and patient-centred outcomes in adults admitted to intensive care units (ICUs).

Design: Retrospective propensity-matched cohort study.

Setting: Mechanically ventilated adults (≥ 18 years) admitted to four Canadian hospital medical/surgical ICUs from 2014 to 2016 in Calgary, Alberta, Canada. Read More

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Automatic continuous EEG signal analysis for diagnosis of delirium in patients with sepsis.

Clin Neurophysiol 2021 Jun 9;132(9):2075-2082. Epub 2021 Jun 9.

Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 1-23, Glostrup, Denmark. Electronic address:

Objective: In critical care, continuous EEG (cEEG) monitoring is useful for delirium diagnosis. Although visual cEEG analysis is most commonly used, automatic cEEG analysis has shown promising results in small samples. Here we aimed to compare visual versus automatic cEEG analysis for delirium diagnosis in septic patients. Read More

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Changes in autonomic tone during delirium in acute stroke patients assessed by pupillometry and skin conductance.

J Neurol Sci 2021 Jul 15;428:117582. Epub 2021 Jul 15.

Department of Neurology, Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark; Department of Clinical Medicine, University of Copenhagen, Panum Institute, Blegdamsvej 3B, 2200 Copenhagen, Denmark.

Delirium is a common complication in acute ischemic stroke, possibly caused by alterations in the regulation of the sympathetic autonomic nervous system. We investigated whether such an association could be demonstrated with two easy-to-use measurement techniques: Measurement of palmar skin conductance level (SCL) and pupillometry measuring the dilation velocity in the pupillary light reflex (PLR). The cohort study included 64 patients admitted with acute ischemic stroke. Read More

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[Treatment of alcohol withdrawal syndrome].

Authors:
Y P Sivolap

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(6):139-144

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

Alcohol withdrawal arises in result of long-lasting or short, but massive, alcohol abuse, manifests itself with oppressive symptoms and in some cases is complicated by seizures, hallucinosis and delirium tremens that may be life-threatening for patients. The leading neurochemical factors underlying alcohol withdrawal syndrome and its complications are lack of GABA and excessive glutamate activity, which is important for therapy choice. The first-line drugs in the treatment of alcohol withdrawal syndrome and alcoholic delirium are benzodiazepines, which have the maximum pharmacological similarity with ethanol. Read More

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Changes in Motor Behavior Predict Falls and Identify Acute Events.

West J Nurs Res 2021 Jul 20:1939459211031981. Epub 2021 Jul 20.

The University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

This study aimed to examine how changes in motor behavior are associated with falls, delirium, and urinary tract infections (UTIs). Twenty-three (128 observations) skilled nursing residents were examined for up to 18 months. In multilevel models, motor behaviors (e. Read More

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Post-infection cognitive impairments in a cohort of elderly patients with COVID-19.

Mol Neurodegener 2021 07 19;16(1):48. Epub 2021 Jul 19.

Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China.

Background: Understanding the long-term effects of coronavirus disease 2019 (COVID-19) on cognitive function is essential for monitoring the cognitive decline in the elderly population. This study aims to assess the current cognitive status and the longitudinal cognitive decline in elderly patients recovered from COVID-19.

Methods: This cross-sectional study recruited 1539 COVID-19 inpatients aged over 60 years who were discharged from three COVID-19-designated hospitals in Wuhan, China, from February 10 to April 10, 2020. Read More

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A Machine Learning Approach for Investigating Delirium as a Multifactorial Syndrome.

Int J Environ Res Public Health 2021 07 2;18(13). Epub 2021 Jul 2.

Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy.

Delirium is a psycho-organic syndrome common in hospitalized patients, especially the elderly, and is associated with poor clinical outcomes. This study aims to identify the predictors that are mostly associated with the risk of delirium episodes using a machine learning technique (MLT). A random forest (RF) algorithm was used to evaluate the association between the subject's characteristics and the 4AT (the 4 A's test) score screening tool for delirium. Read More

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Effects of general versus subarachnoid anaesthesia on circadian melatonin rhythm and postoperative delirium in elderly patients undergoing hip fracture surgery: A prospective cohort clinical trial.

EBioMedicine 2021 Jul 16;70:103490. Epub 2021 Jul 16.

Department of Anesthesiology, Peking University Third Hospital, No. 49, North Garden Street, Haidian District, Beijing 100191, China. Electronic address:

Background: Circadian rhythm disturbance is common postoperatively in older patients with hip fractures, which may contribute to the development of postoperative delirium (POD). As a reliable biomarker of endogenous circadian rhythms, melatonin regulates the sleep-wake cycle and environmental adaptation, and its secretory rhythm may be modified by anaesthesia and surgery. This study compared the impact of subarachnoid anaesthesia (SA) and general anaesthesia (GA), on the peak of melatonin secretion (primary outcome), the circadian rhythm of melatonin, cortisol and sleep, and the POD incidence (secondary outcome). Read More

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COVID-19 Infection: A Neuropsychiatric Perspective.

J Neuropsychiatry Clin Neurosci 2021 Jul 19:appineuropsych20110277. Epub 2021 Jul 19.

Red Cross Hospital, Athens, Greece (T. A. Manolis); Canterbury Christ Church University, Canterbury, United Kingdom (Apostolopoulos); Patras University School of Medicine, Patras, Greece (A. A. Manolis); Onassis Cardiac Surgery Center, Athens, Greece (Melita); and Athens University School of Medicine, Greece (A. S. Manolis).

As a potentially life-threatening disease with no definitive treatment and without fully implemented population-wide vaccination, COVID-19 has created unprecedented turmoil in socioeconomic life worldwide. In addition to physical signs from the respiratory and many other systems, the SARS-CoV-2 virus produces a broad range of neurological and neuropsychiatric problems, including olfactory and gustatory impairments, encephalopathy and delirium, stroke and neuromuscular complications, stress reactions, and psychoses. Moreover, the psychosocial impact of the pandemic and its indirect effects on neuropsychiatric health in noninfected individuals in the general public and among health care workers are similarly far-ranging. Read More

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Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.

Cochrane Database Syst Rev 2021 07 19;7:CD013307. Epub 2021 Jul 19.

Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

Background: Delirium is an acute neuropsychological disorder that is common in hospitalised patients. It can be distressing to patients and carers and it is associated with serious adverse outcomes. Treatment options for established delirium are limited and so prevention of delirium is desirable. Read More

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