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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
June 1, 2007
Troubleshooting Delirium in Elderly Inpatients
Delirium is characterized by an altered level of consciousness, decreased attention span, acute onset, and fluctuating course. Approximately 15% of... More »
May 1, 2007
Psychiatric Evaluations in Emergency Departments
In the article by Drs Kunen and Mandry, "Should Emergency Medicine Physicians Screen for Psychiatric Disorders?" (Psychiatric Times, October 2006), no... More »
May 1, 2007
Regarding the recently published article on delirium, I am interested in what laboratory evaluation is necessary in the emergency department for an evidence-based search of the causes of acute delirium. Which laboratory test results must be back and acted on before the patient is admitted? It would seem that in a patient without a history of trauma and with normal vital signs and a normal neurological examination findings, few studies are indicated and most abnormal laboratory study results...
More »
April 20, 2007
Delirium in Elderly is Common But Preventable
BRADFORD, England -- Well-meaning physicians may unwittingly induce delirium in older patients when they prescribe medications such as antihistamines... More »
April 2, 2007
Management of Delirium
Ms. B is a 44-year-old married African-American female who was diagnosed with locally advanced right breast cancer in 2002.... More »
March 1, 2007
Delirium: Emergency Evaluation and Treatment
Delirium is a disorder that lies at the interface of psychiatry and medicine. It is an acute organic syndrome caused by an underlying medical... More »
Showing 19 - 24 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
Five Steps to Improving Patient Access
Judy Capko,  May 21, 2013
Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
Marion K. Jenkins,  May 21, 2013
Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Finding Physician Work-Life Balance in the Small Moments
Jennifer Frank, MD,  May 21, 2013
At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
Three Areas to Reduce Costs at Your Medical Practice
Greg Mertz,  May 19, 2013
By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog
Michael Woo-Ming, MD,  May 18, 2013
Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
 

 
 
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