scholarly journals Benzodiazepinics and the treatment of delirium: a literature review

2020 ◽  
Vol 66 (7) ◽  
pp. 998-1001
Author(s):  
Otávio Henrique Polles Gonçalves ◽  
Gabriela Manfron Pellissari ◽  
Henrique Soares Paiva
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Cognitive Decline ◽  
Patient Management ◽  
Older Individuals ◽  
Acute Confusional State ◽  
Confusional State ◽  
Pubmed Database ◽  
Year 2000

SUMMARY OBJECTIVE To discuss the role of the benzodiazepine class in delirium patient management. METHODS Using the PubMed database, articles were reviewed after the year 2000 containing in their title the words ‘delirium’ and ‘benzodiazepines’. DISCUSSION Delirium is an acute confusional state that leads to altered attention, awareness, and cognition. It presents with some well-established risk factors, especially older individuals with cognitive decline. There is currently no definite consensus regarding its pathophysiology, nor regarding pharmacological measures, especially concerning the benzodiazepine class. CONCLUSION Evidence suggests that there may be a role for the use of pharmacological class in the treatment of this condition, indicating a change in the previously paradigmatic pattern of treatment.

Role of Nut Consumption in the Management of Cognitive Decline - A Mini-Review

2018 ◽  
Vol 15 (9) ◽  
pp. 877-882 ◽  
Author(s):  
Blanka Klimova ◽  
Kamil Kuca ◽  
Martin Valis ◽  
Jakub Hort
Keyword(s):  
Cognitive Decline ◽  
Cognitive Functions ◽  
Dietary Intervention ◽  
Social Issues ◽  
Older Individuals ◽  
Active Life ◽  
Healthy Nutrition ◽  
Health Aging ◽  
Review Study

Background: Currently, there is a significant increase in the number of older generation groups, which may result in serious economic and social issues. Therefore, there is a need to prolong the active life of these older individuals, especially by focusing on modifying lifestyle factors such as healthy nutrition. In fact, recent research has shown that, for example, nuts are an important part of people’s healthy diet because they have appeared to be neuroprotective compounds which might maintain or in some cases even improve people’s cognitive functions. Objective: The purpose of this review study is to explore the role of the nut nutrition in the maintenance and delay of cognitive decline among older individuals. Results: The findings indicate that the nut consumption may contribute to the delay of cognitive decline in aging. However, this nut diet is just one component of the multi-nutrient dietary intervention for health aging. Conclusion: More longitudinal controlled randomized studies have to be performed in this field to prove the efficacy of the nut nutrition for the delay of cognitive decline.

Methylenetetrahydrofolate reductase polymorphisms as risk factors for retinal venous occlusive disease: A literature review

2021 ◽  
pp. 112067212110006
Author(s):  
Manuel Marques ◽  
Francisco Alves ◽  
Miguel Leitão ◽  
Catarina Rodrigues ◽  
Joana Tavares Ferreira
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Methylenetetrahydrofolate Reductase ◽  
Mthfr C677t ◽  
Mthfr Gene ◽  
Mthfr Polymorphisms ◽  
Vein Occlusion ◽  
C677t Mutation ◽  
Retinal Vascular Disease

The role of polymorphisms of methylenetetrahydrofolate reductase (MTHFR) gene in retinal vein occlusion (RVO) is a theme of discussion since the first reports of RVO in patients with MTHFR C677T mutation and without classic acquired risk factors for retinal vascular disease. The association between MTHFR polymorphisms and RVO has been studied over the last 20 years producing conflicting results. This review aims to summarize the literature concerning the role MTHFR polymorphisms as risk factors for RVO.

scholarly journals Concentrations of the Selected Biomarkers of Endothelial Dysfunction in Response to Antiepileptic Drugs: A Literature Review

2019 ◽  
Vol 25 ◽  
pp. 107602961985942 ◽  
Author(s):  
Beata Sarecka-Hujar ◽  
Izabela Szołtysek-Bołdys ◽  
Ilona Kopyta ◽  
Barbara Dolińska ◽  
Andrzej Sobczak
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Endothelial Dysfunction ◽  
Literature Review ◽  
Antiepileptic Drug ◽  
Asymmetric Dimethylarginine ◽  
The Body ◽  
Biochemical Processes ◽  
The Brain

Epilepsy is a disease arising from morphological and metabolic changes in the brain. Approximately 60% of patients with seizures can be controlled with 1 antiepileptic drug (AED), while in others, polytherapy is required. The AED treatment affects a number of biochemical processes in the body, including increasing the risk of cardiovascular diseases (CVDs). It is indicated that the duration of AED therapy with some AEDs significantly accelerates the process of atherosclerosis. Most of AEDs increase levels of homocysteine (HCys) as well as may affect concentrations of new, nonclassical risk factors for atherosclerosis, that is, asymmetric dimethylarginine (ADMA) and homoarginine (hArg). Because of the role of these parameters in the pathogenesis of CVD, knowledge of HCys, ADMA, and hArg concentrations in patients with epilepsia treated with AED, both pediatric and adult, appears to be of significant importance.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

scholarly journals Metabolic Syndrome, Cognitive Impairment and the Role of Diet: A Narrative Review

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 333
Author(s):  
Matina Kouvari ◽  
Nathan M. D’Cunha ◽  
Nikolaj Travica ◽  
Domenico Sergi ◽  
Manja Zec ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Manifestations ◽  
Narrative Review ◽  
Cognitive Outcomes ◽  
Food Groups ◽  
Cardiometabolic Disorders

Background: This narrative review presents the association between metabolic syndrome (MetS), along with its components, and cognition-related disorders, as well as the potential reversal role of diet against cognitive impairment by modulating MetS. Methods: An electronic research in Medline (Pubmed) and Scopus was conducted. Results: MetS and cognitive decline share common cardiometabolic pathways as MetS components can trigger cognitive impairment. On the other side, the risk factors for both MetS and cognitive impairment can be reduced by optimizing the nutritional intake. Clinical manifestations such as dyslipidemia, hypertension, diabetes and increased central body adiposity are nutrition-related risk factors present during the prodromal period before cognitive impairment. The Mediterranean dietary pattern stands among the most discussed predominantly plant-based diets in relation to cardiometabolic disorders that may prevent dementia, Alzheimer’s disease and other cognition-related disorders. In addition, accumulating evidence suggests that the consumption of specific dietary food groups as a part of the overall diet can improve cognitive outcomes, maybe due to their involvement in cardiometabolic paths. Conclusions: Early MetS detection may be helpful to prevent or delay cognitive decline. Moreover, this review highlights the importance of healthy nutritional habits to reverse such conditions and the urgency of early lifestyle interventions.

scholarly journals Evidence-Based Management of Gout - A Systematic Search and Review

2020 ◽  
Author(s):  
Md Abu Bakar Siddiq
Keyword(s):  
Risk Factors ◽  
Treatment Options ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Pharmacological Agents ◽  
New Synthesis ◽  
Pubmed Database ◽  
Anti Inflammatory ◽  
Clinical Conditions

Gout is the most common form of inflammatory arthritis. Hyperuricaemia is the pre-requisite for gout and is influenced by variable modifiable and non-modifiable risk factors. Clinical features unique for gout are due to deposition of monosodium urate (MSU) crystal in articular and extra articular tissues. Among various treating agents, anti-inflammatory drugs and urate lowering therapies (ULT) are used widely and successfully, however, non-medicinal means are also effective in the disorder. In their updated guidelines, ACR (2012) and EULAR (2016) recommended both medicinal and non-medicinal approaches that could be used in treating gout, though some of the recommendations are based on lower level of evidence. Moreover, researchers’ continued effort in finding new gout managing agents appear promising, for example, role of Lesinurad in gout management (CLEAR1, CLEAR2). In this new synthesis the author is aimed to provide updated information on gout management based on a systematic review including published work within last ten years between 2008 and 2018 and for this purpose, using ‘clinical trials in gout management’ string, published worked searched in PubMed database from 1st September 2018 to 30 October 2018. Besides the recent ACR and EULAR evidence based management guidelines, the author reviewed another 91 (total 93) articles to make this new draft – 39 articles describe role of pharmacological agents and 54 describe different gout risks, pharmacokinetics/pharmacodynamics of ULT, association between raised sUA level and renal impairment, efficacy of non-pharmacological agents in reducing sUA. According to published work, anti-inflammatory agent is the most appropriate drug group in mitigating inflammatory symptoms of gout, though they often adversely affect over other vital 2 organs with impaired function. Besides ULT, uricase analogues are also found useful in non refractory gout. Since anti-inflammatory agents and ULT contraindicate in some clinical conditions, intra-articular steroid and or adrenocorticotropic hormone (ACTH) are appropriate alternatives instead. However, head-to-head comparison between different NSAIDs, NSAID and prednisolone, NSAID and colchicine are yet to perform. Use of combined anti-inflammatory preparations in gout is also based on lower level of evidence. Regarding effective maximum dose and long-standing impact of ULT on vital organs we are yet to reach a conclusion. Likewise, non-medicinal approaches are widely using in achieving target sUA level, though some of them are based on biased study outcomes and or study with inadequate power, requiring further analysis. Among non-pharmacological approaches, life-style modification, restriction of purine rich diets, avoidance of gout inciting agents are important, but inconclusive. Educating patients’ about diseases, risk factors, available treatment options and side effects from them are also important in terms of achieving sUA level, nevertheless too much counseling sometimes could be worthless.

scholarly journals Dental biofilm-induced gingivitis in children and adolescents. A literature review

2021 ◽  
Vol 26 (3) ◽  
pp. 2664-2670
Author(s):  
ȘTEFANA POPA ◽  
◽  
STANA PĂUNICĂ ◽  
MARINA CRISTINA GIURGIU ◽  
DANA BODNAR ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Children And Adolescents ◽  
Bacterial Colonization ◽  
Size Consistency ◽  
Dental Biofilm ◽  
Microbial Etiology ◽  
Local Risk ◽  
The Times

Dental biofilm-induced gingivitis is extremely common in children and adolescents and it affects the majority of children over 7 years old. It is characterised by inflammation, consisting in changes of colour, size, consistency and texture. Although most of the times gingivitis does not progress into periodontitis, it is important to diagnose and properly treat this disease, as gingivitis precedes periodontitis. The present paper aims to review the main findings of microbial etiology and epidemiology of dental biofilm-induced gingivitis mediated by local risk factors, as well as the role of oral hygiene in preventing bacterial colonization.

scholarly journals Vascular factors in the genesis of dementia and the optimization of patient management

2019 ◽  
Vol 11 (2) ◽  
pp. 106-114
Author(s):  
O. D. Ostroumova ◽  
A. I. Kochetkov
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Coronary Artery Bypass Surgery ◽  
Patient Management ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Age Groups ◽  
Postoperative Cognitive Dysfunction ◽  
Vascular Risk

The review considers the problem of cognitive impairment (CI) and dementia in patients from older age groups, as well as the safety of antidementia agents with a focus on adverse cardiovascular drug reactions. Special attention is paid to the role of cardiovascular risk factors in the genesis of CI and all types of dementia. It is emphasized that the treatment of patients with CI is primarily aimed at monitoring vascular risk factors, preventing stroke and progression of chronic cerebrovascular disease, and, therefore, improving cognitive functions. Postoperative cognitive dysfunction in elderly patients, in particular during coronary artery bypass surgery, is highlighted. Non-drug and drug measures to prevent the progression of CI and dementia are described in detail. The significant importance of multimorbidity and polypragmasia in elderly patients with dementia is noted; data on the cardiovascular safety of anti-dementia drugs are presented.

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