Changes in Mental Status

2004 ◽  
Vol 94 (2) ◽  
pp. 118-125
Author(s):  
Alicia J. Curtin
Keyword(s):  
At Risk ◽  
Mental Status ◽  
Clinical Assessment ◽  
Older Patients ◽  
Medical Condition ◽  
Hospital Setting ◽  
Common Symptom ◽  
Patients At Risk ◽  
Hospitalized Patient ◽  
High Level

Change in mental status is a common symptom in the older, hospitalized patient. Often referred to as delirium, it may be the first indication of a serious medical condition. If delirium is not identified and treated promptly, it may lead to severe complications. The podiatric physician can prevent many cases of delirium by maintaining a high level of suspicion, performing a thorough clinical assessment, and identifying older patients at risk in the hospital setting. (J Am Podiatr Med Assoc 94(2): 118-125, 2004)

scholarly journals Overview of Tertiary Addictions Services response to Opioid dependence during the COVID-19 Pandemic

2021 ◽  
pp. 1-14
Author(s):  
K Hennigan ◽  
E Corrigan ◽  
N Killeen ◽  
E Keenan ◽  
M Scully
Keyword(s):  
At Risk ◽  
Opioid Dependence ◽  
Medication Management ◽  
Health Problems ◽  
Healthcare Staff ◽  
Addiction Services ◽  
Patients At Risk ◽  
Guidance Documents ◽  
High Level ◽  
Opioid Users

Abstract The emergence of the COVID-19 pandemic has presented the addiction services with an unprecedented set of challenges. Opioid users are particularly vulnerable because of their high level of pre-existing health problems and lifestyle factors. In order to minimise their risks to self and to others in the current Covid-19 crisis, the service has sought to urgently identify vulnerable individuals, and induct them into OST treatment promptly. Additionally, several guidelines have been created and regularly updated by the HSE for any healthcare staff working with opioid users. These include guidance documents, to facilitate prompt induction of patients onto the OST programme, the prescribing of naloxone to all patients at risk of overdose, eConsultation, medication management for those in self-isolation, and the delivery of injecting equipment. The guidance documents and resources will provide a template for a new way of working for the sector during these challenging times and into the future.

scholarly journals Real-time utilisation of administrative data in the ED to identify older patients at risk: development and validation of the Dynamic Silver Code

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033374 ◽  
Author(s):  
Daniela Balzi ◽  
Giulia Carreras ◽  
Francesco Tonarelli ◽  
Luca Degli Esposti ◽  
Paola Michelozzi ◽  
...  
Keyword(s):  
At Risk ◽  
Cohort Study ◽  
Real Time ◽  
Administrative Data ◽  
Older Patients ◽  
Clinical Decision Making ◽  
External Validation ◽  
Clinical Decision ◽  
Patients At Risk ◽  
Ed Visits

ObjectiveIdentification of older patients at risk, among those accessing the emergency department (ED), may support clinical decision-making. To this purpose, we developed and validated the Dynamic Silver Code (DSC), a score based on real-time linkage of administrative data.Design and settingThe ‘Silver Code National Project (SCNP)’, a non-concurrent cohort study, was used for retrospective development and internal validation of the DSC. External validation was obtained in the ‘Anziani in DEA (AIDEA)’ concurrent cohort study, where the DSC was generated by the software routinely used in the ED.ParticipantsThe SCNP contained 281 321 records of 180 079 residents aged 75+ years from Tuscany and Lazio, Italy, admitted via the ED to Internal Medicine or Geriatrics units. The AIDEA study enrolled 4425 subjects aged 75+ years (5217 records) accessing two EDs in the area of Florence, Italy.InterventionsNone.Outcome measuresPrimary outcome: 1-year mortality. Secondary outcomes: 7 and 30-day mortality and 1-year recurrent ED visits.ResultsAdvancing age, male gender, previous hospital admission, discharge diagnosis, time from discharge and polypharmacy predicted 1-year mortality and contributed to the DSC in the development subsample of the SCNP cohort. Based on score quartiles, participants were classified into low, medium, high and very high-risk classes. In the SCNP validation sample, mortality increased progressively from 144 to 367 per 1000 person-years, across DSC classes, with HR (95% CI) of 1.92 (1.85 to 1.99), 2.71 (2.61 to 2.81) and 5.40 (5.21 to 5.59) in class II, III and IV, respectively versus class I (p<0.001). Findings were similar in AIDEA, where the DSC predicted also recurrent ED visits in 1 year. In both databases, the DSC predicted 7 and 30-day mortality.ConclusionsThe DSC, based on administrative data available in real time, predicts prognosis of older patients and might improve their management in the ED.

scholarly journals Can routine clinical data identify older patients at risk of poor healthcare outcomes on admission to hospital?

2017 ◽  
Vol 10 (1) ◽  
Author(s):  
Kinda Ibrahim ◽  
Charlotte Owen ◽  
Harnish P. Patel ◽  
Carl May ◽  
Mark Baxter ◽  
...  
Keyword(s):  
At Risk ◽  
Clinical Data ◽  
Older Patients ◽  
Healthcare Outcomes ◽  
Patients At Risk

scholarly journals The association of kidney function and cognitive decline in older patients at risk of cardiovascular disease: a longitudinal data analysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Laurien E. Zijlstra ◽  
Stella Trompet ◽  
Simon P. Mooijaart ◽  
Marjolijn van Buren ◽  
Naveed Sattar ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
At Risk ◽  
Data Analysis ◽  
Longitudinal Data ◽  
Cognitive Decline ◽  
Kidney Function ◽  
Older Patients ◽  
Longitudinal Data Analysis ◽  
Patients At Risk

Biomarkers of Ischemic Stroke

US Neurology ◽  
2010 ◽  
Vol 05 (02) ◽  
pp. 52
Author(s):  
Glen Jickling ◽  
Huichun Xu ◽  
Frank Sharp ◽  
◽  
◽  
...  
Keyword(s):  
At Risk ◽  
Ischemic Stroke ◽  
Clinical Diagnosis ◽  
Clinical Assessment ◽  
Molecular Biomarkers ◽  
Patient Treatment ◽  
Diagnosis And Management ◽  
Genomic Markers ◽  
Patients At Risk ◽  
Risk Of Disease

The diagnosis and management of patients with ischemic stroke is primarily based on clinical assessment in conjunction with imaging tests. Development of molecular biomarkers as additional tools to support a clinical diagnosis, identify patients at risk of disease, and help guide patient treatment and prognosis would be of great value. Currently, no such biomarkers are used in the management of patients with ischemic stroke; however, several promising proteomic and genomic markers have been identified, as presented in this review.

scholarly journals Nutritional Advice in Older Patients at Risk of Malnutrition during Treatment for Chemotherapy: A Two-Year Randomized Controlled Trial

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e108687 ◽  
Author(s):  
Isabelle Bourdel-Marchasson ◽  
Christelle Blanc-Bisson ◽  
Adélaïde Doussau ◽  
Christine Germain ◽  
Jean-Frédéric Blanc ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Older Patients ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Nutritional Advice ◽  
Patients At Risk

scholarly journals RESISTANCE CONFERRING MUTATIONS IN SARS-CoV-2 DELTA FOLLOWING SOTROVIMAB INFUSION

2021 ◽  
Author(s):  
Rebecca J Rockett ◽  
Kerri Basile ◽  
Susan Maddocks ◽  
Winkie Fong ◽  
Jessica E Agius ◽  
...  
Keyword(s):  
At Risk ◽  
Rapid Development ◽  
Severe Disease ◽  
Gene Mutations ◽  
Regulatory Agencies ◽  
Spike Gene ◽  
Treatment And Prevention ◽  
Patients At Risk ◽  
High Level

Several Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) neutralising monoclonal antibodies (mAbs) have received emergency use authorisation by regulatory agencies for treatment and prevention of Coronavirus Disease 2019 (COVID-19), including in patients at risk for progression to severe disease. Here we report the persistence of viable SARS-CoV-2 in patients treated with sotrovimab and the rapid development of spike gene mutations that have been shown to confer high level resistance to sotrovimab in vitro. We highlight the need for SARS-CoV-2 genomic surveillance in at risk individuals to inform stewardship of mAbs use and prevent potential treatment failures.

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