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NEWS
Post-Op Delirium May Impair Thinking for Year (CME/CE)
www.medpagetoday.com - 7/4/12
Delirium Common in Hospitalized Alzheimer's Patients (CME/CE)
www.medpagetoday.com - 6/18/12
Medical News: Postop Delirium More Frequent If Alzheimer's-Linked Allele Present
www.medpagetoday.com -

 
PATIENT RESOURCES
Hallucinations
ghr.nlm.nih.gov - 12/16/12
Delirium: MedlinePlus
www.nlm.nih.gov - 6/19/12
NIHSeniorHealth: Prescription and Illicit Drug Abuse
nihseniorhealth.gov - 6/4/12
 
CLINICAL TRIALS
The MIND Study: Modifying the INcidence of Delirium
www.clinicaltrials.gov -
MENDS Study: Trial in Ventilated ICU Patients Comparing an Alpha2 Agonist Versus a Gamma Aminobutyric Acid (GABA)-Agonist to Determine Delirium Rates, Efficacy of Sedation, Analgesia and Discharge Cognitive Status
www.clinicaltrials.gov -
Improved ICU Outcomes With Protocolized Management of Analgesia, Sedation and Delirium
www.clinicaltrials.gov -

 
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Delirium
 
LATEST FEATURES
March 15, 2010
Cancer Management Chapter 36: Depression, anxiety, and delirium
Although many cancer patients cope well with their disease, psychiatric disorders occur in almost 50% of patients in the setting of malignancy.... More »
January 27, 2010
Delirium
More »
July 10, 2009
Delirium With Catatonic Features: A New Subtype?
Delirium has been recognized and described since antiquity. It is a brain disturbance manifested by a syndrome of diverse neuro­­psychiatric symptoms.... More »
March 30, 2009
Ebola Hemorrhagic Fever and Marburg Hemorrhagic Fever
Ebola virus and Marburg virus are responsible for Ebola hemorrhagic fever (EHF) and Marburg hemorrhagic fever (MHF), respectively. More »
February 1, 2009
Intoxication with street drugs: Cocaine and amphetamines

Cocaine and amphetamine intoxication continue to be common causes of emergency department and hospital admissions. The differential diagnosis... More »

August 28, 2008
An apical cavitary lesion in a 51-year-old man
More »
Showing 7 - 12 of 44 results.
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JOURNAL SCAN
Efficacy of Plasma Exchange in Pharmaco-Resistant Acute Mania in Systemic Lupus Erythematosus
psychiatryonline.org - 11/30/13
Reversible Dementia in Young Persons Due to Cobalamin Deficiency
psychiatryonline.org - 11/30/13
Delirium within the emergency care setting, occurrence and detection: a systematic review
emj.bmj.com - 3/19/13
Highlights from this issue
emj.bmj.com - 3/19/13
Perioperative Dexmedetomidine Improves Outcomes of Cardiac Surgery [Original Articles]
circ.ahajournals.org - 3/19/13
 
MEDLINE
Comprehensive approaches to managing delirium in patients with advanced cancer.
pubmed.gov - 1/31/13
Delirium is a frequently under-recognized complication in patients with advanced cancer. Uncontrolled delirium eventually leads to significant distress to patients and their families. However, delirium episodes can be reversed in half of these patients by eliminating precipitating factors and using appropriate interventions. The purpose of this narrative review is to discuss the most recent updates in the literature on the management of delirium in patients with advanced cancer. This article addresses the epidemiology, cause, pathophysiology, clinical characteristics, and assessment of delirium as well as various treatment options, including nonpharmacologic intervention and palliative sedation.
Parenteral hydration in patients with advanced cancer: a multicenter, double-blind, placebo-controlled randomized trial.
pubmed.gov - 12/31/12
The vast majority of patients with cancer at the end of life receive parenteral hydration in hospitals and no hydration in hospice, with limited evidence supporting either practice. In this randomized controlled trial, we determined the effect of hydration on symptoms associated with dehydration, quality of life, and survival in patients with advanced cancer.|We randomly assigned 129 patients with cancer from six hospices to receive parenteral hydration (normal saline 1 L per day) or placebo (normal saline 100 mL per day) daily over 4 hours. The primary outcome was change in the sum of four dehydration symptoms (fatigue, myoclonus, sedation and hallucinations, 0 = best and 40 = worst possible) between day 4 and baseline. Secondary outcomes included Edmonton Symptom Assessment Scale (ESAS), Memorial Delirium Assessment Scale (MDAS), Nursing Delirium Screening Scale (NuDESC), Unified Myoclonus Rating Scale (UMRS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F),
Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.
pubmed.gov - 12/14/12
Critical illness and its treatment often result in long-term neuropsychiatric morbidities. Consequently, there is a need to focus on means to prevent or ameliorate these morbidities. Animal models provide important data regarding the neurobiological effects of physical activity, including angiogenesis, neurogenesis, and release of neurotrophic factors that enhance plasticity. Studies in noncritically ill patients demonstrate that exercise is associated with increased cerebral blood flow, neurogenesis, and brain volume, which are associated with improved cognition. Clinically, research in both healthy and diseased human subjects suggests that exercise improves neuropsychiatric outcomes. In the critical care setting, early physical rehabilitation and mobilization are safe and feasible, with demonstrated improvements in physical functional outcomes. Such activity may also reduce the duration of delirium in the intensive care unit (ICU) and improve neuropsychiatric outcomes, although data
Randomized comparison of sevoflurane versus propofol to reduce perioperative myocardial ischemia in patients undergoing noncardiac surgery.
pubmed.gov - 12/3/12
Volatile anesthetics provide myocardial preconditioning in coronary surgery patients. We hypothesized that sevoflurane compared with propofol reduces the incidence of myocardial ischemia in patients undergoing major noncardiac surgery.|We enrolled 385 patients at cardiovascular risk in 3 centers. Patients were randomized to maintenance of anesthesia with sevoflurane or propofol. We recorded continuous ECG for 48 hours perioperatively, measured troponin T and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) on postoperative days 1 and 2, and evaluated postoperative delirium by the Confusion Assessment Method. At 6 and 12 months, we contacted patients by telephone to assess major adverse cardiac events. The primary end point was a composite of myocardial ischemia detected by continuous ECG and/or troponin elevation. Additional end points were postoperative NT-proBNP concentrations, major adverse cardiac events, and delirium. Patients and outcome assessors were blinded. We
Symptoms of delirium occurring before and after episodes of delirium in older long-term care residents.
pubmed.gov - 11/30/12
To describe Confusion Assessment Method (CAM) core symptoms of delirium occurring before and after incident episodes of delirium in older long-term care (LTC) residents. A secondary objective was to describe the mean number of symptoms before and after episodes by dementia status.|Secondary analysis of data collected for a prospective cohort study of delirium, with repeated weekly assessments for up to 6 months.|Seven LTC facilities in Montreal and Quebec City, Canada.|Forty-one older LTC residents who had at least one CAM-defined incident episode of delirium.|The Mini-Mental State Examination (MMSE), CAM, Delirium Index (DI), Hierarchic Dementia Scale, Barthel Index, and Cornell Scale for Depression were completed at baseline. The MMSE, CAM, and DI were repeated weekly for 6 months. The frequency, mean number, type, and duration of CAM core symptoms of delirium occurring before and after incident episodes were examined using descriptive statistics, frequency analysis, and survival
 
PRACTICE GUIDELINES
National Guideline Clearinghouse | Guidelines by Topic: Alcohol Withdrawal Delirium
www.guidelines.gov -
NGC is the National Guideline Clearinghouse.
National Guideline Clearinghouse | Guidelines by Topic: Delirium
www.guidelines.gov -
NGC is the National Guideline Clearinghouse.
National Guideline Clearinghouse | Guidelines by Topic: Delirium, Dementia, Amnestic, Cognitive Disorders
www.guidelines.gov -
NGC is the National Guideline Clearinghouse.
National Guideline Clearinghouse | (1) Screening for delirium, dementia and depression in older adults. (2) Screening for delirium, dementia and depression in older adults 2010 supplement.
www.guidelines.gov -
(1) Screening for delirium, dementia and depression in older adults. (2) Screening for delirium, dementia and depression in older adults 2010 supplement.
National Guideline Clearinghouse | Delirium: prevention, early recognition, and treatment. In: Evidence-based geriatric nursing protocols for best practice.
www.guidelines.gov -
Delirium: prevention, early recognition, and treatment. In: Evidence-based geriatric nursing protocols for best practice.



 
FROM PHYSICIANS PRACTICE
Primary Care Can't Thrive Without Nurse Practitioners
Courtney H. Lyder, ND,  May 17, 2013
With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
VWhat Physicians Can Learn from the Allscripts EHR Lawsuit
Marisa Torrieri,  May 16, 2013
Lawsuit prompts question: What should physicians do to ensure they end up with a great EHR instead of buyer’s remorse?
Eight Ways ICD-9 Will Still Matter to Medical Practices
Brenda Edwards, CPC,  May 15, 2013
What should your medical practice do with your ICD-9-CM book after October 1, 2014? Keep it.
Seven Ways Technology Can Speed Up Patient Collections
Cheyenne Brinson,  May 15, 2013
Failing to adopt widely available billing and collections technology can cost medical practices big. Here's how to do it right.
Four Reasons Private Medical Practice is Becoming Extinct
Carol Stryker,  May 15, 2013
It’s becoming increasingly difficult for private medical practices to thrive. Here’s what’s driving the trend toward consolidation.
 

 
 
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