Precipitating and Predisposing Factors of Acute Confusional State Among Emergency Department Patients

1995 ◽  
Vol 7 (4) ◽  
pp. 519-526 ◽  
Author(s):  
Sölve Elmståhl ◽  
Christer Wahlfrid ◽  
Peter Jerntorp
Keyword(s):  
Medical Records ◽  
Predisposing Factors ◽  
Control Group ◽  
Precipitating Factors ◽  
Acute Confusional State ◽  
Metabolic Disturbances ◽  
Confusional State ◽  
Acute Medical Unit ◽  
Group A ◽  
Emergency Department Patients

The aim of this study was to examine predisposing and precipitating factors of acute confusional state (ACS) retrospectively in medical records of patents examined in an acute medical unit (AMU) who had a preliminary diagnosis of confusion/anxiety. The study comprised all 221 patients who were 65 years old and older among the 18,015 patients examined in the AMU during 1 year who, after a preliminary examination in the AMU, received a diagnosis of confusion/anxiety without any other etiologic diagnosis. Fifty-six cases fulfilled the DSM-III-R criteria for ACS. The control group comprised 165 patients, with anxiety, depression, or psychosis the main finding in 135 cases. Among patients further examined in other departments or for whom consultations were made, the medical records showed that the ACS group had on average 2.6 predisposing factors for ACS, with dementia, cerebrovascular disease, and sensory deficits the most common. Three to six predisposing factors were found among 46% of the ACS patients, compared to 4% of the control group. A precipitating factor of ACS was found in 78% of the ACS cases, and the average number of precipitating factors was 1.6. Dementia (32%), metabolic disturbances (30%), and cardiovascular diseases (16%) were the most frequent precipitating factors among the ACS group. The mortality rates 2 years after examination in the AMU were 32% for the ACS group and 20% for the control group (p < .05). The study suggests that the causes of ACS are often multifactorial and that it is important to seek several precipatating factors when treating this potentially reversible condition.

Delirium in Hospitalized Older Patients: Recognition and Risk Factors

1998 ◽  
Vol 11 (3) ◽  
pp. 118-125 ◽  
Author(s):  
Sharon K. Inouye
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Older Patients ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Precipitating Factors ◽  
Acute Confusional State ◽  
Confusional State ◽  
Confusion Assessment ◽  
Simplified Algorithm

Delirium, or acute confusional state, represents a common, serious, potentially preventable and increasing problem for older hospitalized patients. This study is intended to improve overall understanding of the problem of delirium and thus to lessen its adverse impact on the older population. The specific aims of this study are (1) to examine the epidemiology of delirium in older patients; (2) to evaluate barriers to recognition; (3) to present the Confusion Assessment Method (CAM) simplified algorithm to improve recognition; (4) to elucidate predisposing and precipitating factors for delirium; and (5) to propose preventive strategies. Delirium occurs in 10-60% of the older hospitalized population and is unrecognized in 32-66% of cases. The CAM algorithm provides a sensitive (94-100%), specific (90-95%), reliable, and easy to use means for identification of delirium. Four predisposing and five precipitating factors were identified and validated to identify patients at high risk for development of delirium. Primary prevention of delirium should address important delirium risk factors and target patients at intermediate to high risk for delirium at admission.

Evaluation and Management of Delirium

2021 ◽  
Vol 41 (05) ◽  
pp. 572-587
Author(s):  
Sophia L. Ryan ◽  
Eyal Y. Kimchi
Keyword(s):  
Traumatic Experience ◽  
Precipitating Factors ◽  
Acute Confusional State ◽  
Careful Evaluation ◽  
Confusional State ◽  
Delirious Patient ◽  
Delirium Management ◽  
Poor Outcomes ◽  
Nonpharmacologic Intervention ◽  
Enhance Patient Care

AbstractDelirium, sometimes referred to as encephalopathy, is an acute confusional state that is both common in hospitalized patients and associated with poor outcomes. For patients, families, and caregivers, delirium can be a traumatic experience. While delirium is one of the most common diagnoses encountered by the consulting neurologist, the majority of the time it will have been previously unrecognized as such by the care team. Neurologic syndromes such as dementia or aphasia can either be misdiagnosed as delirium or may coexist with it, necessitating careful neurologic assessment. Once the diagnosis of delirium has been established, a careful evaluation for predisposing and precipitating factors can help uncover modifiable contributors, which should be addressed as part of a multicomponent, primarily nonpharmacologic intervention. Importantly, delirium management, which begins with comprehensive prevention, should emphasize the humanity of the delirious patient and the challenges of caring for this vulnerable population. When considered, delirium represents an important opportunity for the neurologist to substantially enhance patient care.

Risk factors in patients with herpes zoster infections: case-control study

Open Medicine ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. 493-498
Author(s):  
Maja Pezer ◽  
Vjeran Vidić ◽  
Jadranka Nikolić ◽  
Ivo Curić ◽  
Jurica Arapović
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Medical Records ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Significant Difference ◽  
Group A ◽  
Reactivation Mechanism ◽  
Control Study

AbstractThe aim of this study was to determine the prevalence of chronic disease and the risk factors for herpes zoster infection. In this case-control study medical records were collected from 55 patients who presented with herpes zoster and 54 patients in a control group who presented with gastroenterocolitis. Both groups were treated at the Clinic for Infectious Diseases, University Clinical Hospital Mostar from January, 2005 to December, 2010. When we compared the herpes zoster group with the control group, we did not demonstrate any significant difference in the overall prevalence of chronic diseases. However, the prevalence of diabetes and cancer was statistically higher when compared to the control group. A statistically significant difference in the number of cigarette smokers was not observed, whereas the number who consumed alcohol in the herpes zoster group was significantly higher compared to the control group. The correlation between alcohol and herpes zoster could help in solving the reactivation mechanism of VZV.

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

ZINC IN THE RATIONS OF CALVES

2019 ◽  
Keyword(s):  
Body Mass ◽  
Test Group ◽  
Hair Follicles ◽  
Control Group ◽  
Albumin Concentration ◽  
Zinc Compounds ◽  
Entire Duration ◽  
Zinc Salts ◽  
Group A ◽  
Hair Cortex

According to the Tambovagrochemcenter data, zinc deficiency in animal rations exceeds 33%. To de-termine the efficiency of ration additives 3 groups of calves were formed, one of which was control and received regular feed, first test group received additional Zinc Sulphate, and second test group received additional Zinc Bioplex. To assess the results, we take into account the following values: chemical com-position and nutritional values of the feed, body mass value, amount of immunoglobulins in blood, bio-chemical and hematological values of blood, morphological values of fur and skin. Noticeable results were achieved in 4 months, with first and second test groups receiving accordingly 3,15% and 6,13% more body mass increase over the control group. A tendency towards higher albumin concentration in both test groups was noted, and calves of the second test group had higher amounts of hemoglobin and higher concentrations of it per erythrocyte. In samples of epidermis and hairs of the second test group the papillary layer was well developed, with the amount of hair and hair follicles exceeding 7 in the field of view, with the thickness of hairs being at least 70 μm. Inner papilla of hair contained 6 to 8 layers of hair, thickness of awn hairs reaching 80-90 μm, down hairs reaching 40 μm, with the hair cortex making up more than 80% of the hair thickness. Thus, introducing zinc salts and chelated zinc compounds to the milk-fed calves’ ration, has resulted in monetary profit increases over the control group by 255,0 and 612,0 roubles accordingly. By all researched values, the highest results were reached from adding zinc bioplex with approximately 360 mg added per animal for the entire duration of the growth process.

Maximum Temperature Through a Yttrium Stabilized Zirconia Ceramic After Er,Cr:YSGG Laser Irradiation

2020 ◽  
Vol 02 ◽  
Author(s):  
Laurel Stringer ◽  
Sarah Malley ◽  
Darrell M. Hutto ◽  
Jason A. Griggs ◽  
Susana M. Salazar Marocho
Keyword(s):  
High Speed ◽  
Potential Method ◽  
Maximum Temperature ◽  
Zirconia Ceramic ◽  
Tooth Pulp ◽  
Control Group ◽  
Stabilized Zirconia ◽  
Significant Difference ◽  
Power Setting ◽  
Group A

Background: The most common approach to remove yttria stabilized zirconia (YSZ) fixed-dental prostheses (FDPs) is by means of diamond burs attached to a high-speed handpiece. This process is time-consuming and destructive. The use of lasers over mechanical instrumentation for removal of FDPs can lead to efficient and predictable restoration retrievability. However, the heat produced might damage the tooth pulp (>42˚C). Objective: The purpose of this study was to determine the maximum temperature (T) reached during the use of different settings of the erbium, chromium:yttrium-scandium-gallium-garnet Er,Cr:YSGG laser through a YSZ ceramic. Methods: YSZ slices (1 mm thick) were assigned into 7 groups. For the control group, a diamond bur was used to cut a 1 mm groove into the YSZ slices. For the 6 experimental groups, the laser was operated at a constant combination of 33% water and 66% air during 30 s with two different power settings (W) at three frequencies (PPS), as follows (W/PPS): 2.5/20, 2.5/30, 2.5/45, 4.5/20, 4.5/30, 4.5/45. The T through the YSZ slice was recorded in degrees Celsius by using a digital thermometer with a K thermocouple. Results: The median T of the control group was 26.5˚C. The use of 4.5 W resulted in the median T (˚C) of 44.2 at 20 PPS, 53.3 at 30 PPS, and 58.9 at 45 PPS, while 2.5 W showed 34.6, 31.6, and 25.0 at 20, 30, and 45 PPS, respectively. KruskalWallis one-way ANOVA showed that within each power setting, the T was similar. The high power and lowest frequency (4.5/20) showed no significant difference from the 2.5 W settings and the control group. Conclusion: The lower power setting (2.5 W) is a potential method for the use of the Er,Cr:YSGG laser to debond YSZ structures. The higher power (4.5 W) with high frequencies (30 and 45 PPS) is unsuitable.

Clinical effect of Suvarna Bindu Prashan

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Patil Aniket ◽  
Dindore Pallavi ◽  
Arbar Aziz ◽  
Kadam Avinash ◽  
Saroch Vikas
Keyword(s):  
Physical Health ◽  
Eating Habits ◽  
Control Group ◽  
Inform Consent ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Immune Booster ◽  
Mental And Physical Health ◽  
Apparently Healthy

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.

Feedback based on health advice via tracing bracelet and smartphone in the management of Blood Pressure among hypertensive patients: A Community-based RCT Trial in Chongqing, China (Preprint)

2020 ◽  
Author(s):  
Yong Zhang ◽  
Yang Tao ◽  
Yun Zhong ◽  
Jacqueline Thompson ◽  
Jamal Rahmani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Control Group ◽  
Community Settings ◽  
Post Intervention ◽  
Attrition Rates ◽  
Hypertensive Patients ◽  
Professional Health ◽  
Group A ◽  
And Control ◽  
Study Intervention

UNSTRUCTURED Lifestyle interventions have been recognised as a line treatment of non-communicable diseases. The aimed of this study was to evaluate a bespoke mHealth approach to delivers personalised feedback to improve blood pressure and weight for hypertensive patients in community settings. A total of 307 participants, 50 from each community, were expected to be in the intervention or control group. A professional health facilitator was assigned for each of the 6 communities. The primary outcomes of the study are the reduction in blood pressure and weight at baseline and post-intervention. Of 307 recruited,192 (62.5%) participants completed the study (intervention: 104 and control: 88). There was no difference in attrition rates between the two groups (33.5%vs41.9%, p=0.291). After 6-months of intensive feedback intervention through mHealth approach, patients had better blood pressure, weight, and BMI compared with control. People who were adherent to the intervention demonstrated a clinical benefit with regards to weight and blood pressure.

scholarly journals Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma

2016 ◽  
Vol 44 (6) ◽  
pp. 243
Author(s):  
Ariyanto Harsono
Keyword(s):  
Childhood Asthma ◽  
Low Dose ◽  
Sublingual Immunotherapy ◽  
Disease Onset ◽  
Ethics Committee ◽  
Subcutaneous Immunotherapy ◽  
Control Group ◽  
High Dose ◽  
Treat Ment ◽  
Group A

Background Evidence begin to accumulate that high-dose sub-lingual immunotherapy (SLIT) is as effective as subcutaneousimmunotherapy (SIT) in the treatment of childhood asthma.Since the capacity of sublingual area is similar whether the doseis high or low, the efficacy of low dose may be important to bestudied.Objective To investigate the efficacy of low-dose sublingual im-munotherapy in the treatment of childhood asthma.Methods Parents signed informed consent prior to enrollment,after having received information about the study. Patients weremoderate asthma aged 6-14 years with disease onset of lessthan 2 years before the commencement of the study and peakexpiratory flow rate (PEFR) variability of more than 15%. Pa-tients were randomly allocated into group A, B, and C whoreceived subcutaneous immunotherapy, low-dose sublingualimmunotherapy, and conventional asthma therapy, respectively.Randomization was stratified into two strata according to agei.e., 6-11 years or 11-14 years. Patients of each stratum wererandomized in block of three for each group. At the end of threemonths, lung function tests were repeated. The primary outcomewas PEFR variability at the end of the study. The study wasapproved by the Ethics Committee of Soetomo HospitalSurabaya.Results Distribution of variants as represented by sex, age,eosinophil count, and total IgE concentration were normal inthe three groups. PEFR variability decreased significantly from16.97+0.81 to 8.50+5.08 and 17.0+0.87 to 8.40+4.72 in groupreceiving SIT and SLIT, respectively (p<0.05), but decreasednot significantly from 17.00+0.83 to 10.82+0.5.41 in control group(p>0.05).Conclusion Low-dose SLIT is as efficacious as SIT in the treat-ment of moderate asthma in children

Effect of Opuntia dejecta (Salm-Dyck) flowers in liver of fructose-fed rats: Biochemicals, enzymatic and histological studies

2021 ◽  
pp. 096032712110134
Author(s):  
O Zouaoui ◽  
K Adouni ◽  
A Jelled ◽  
A Thouri ◽  
A Ben Chrifa ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Activity ◽  
Body Weight ◽  
Diabetes Type 2 ◽  
Male Rats ◽  
Control Group ◽  
Standard Drug ◽  
High Fructose ◽  
Group A ◽  
Histological Architecture

Phytochemical composition and antioxidant activity of flowers decoction at post-flowering stage (F3D) of Opuntia dejecta were determined. The obtained findings demonstrate that F3D has a marked antioxidant activity in all tested assays. Furthermore, the present study was designed to test the protective activity of F3D against induced Diabetes type 2 (DT2) in male rats. Those metabolic syndromes were induced by a high-fructose diet (HFD) (10% fructose solution) for a period of 20 weeks. F3D was administered orally (100 and 300 mg/kg body weight) daily for the last 4 weeks. Metformin (150 mg/kg body weight) was used as a standard drug and administrated orally for the last 4 weeks. The results showed a significant increase in blood glucose, triglycerides and hepatic markers (ALAT, ASAT and ALK-P) in HFD group. A significant increase in hepatic TBARS and a significant decrease in SOD, CAT and GPX were observed in fructose fed rats compared to control group. Administration of F3D showed a protective effect in biochemical and oxidative stress parameters measured in this study. Also, oral administration of F3D restored the histological architecture of rat liver in comparison with rats fed HFD. In conclusion, F3D attenuated hepatic oxidative stress in fructose-fed rats.

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