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Topic: Delirium

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	MedlinePlus Medical Encyclopedia: Delirium
		Delirium is a condition of severe confusion and rapid changes in brain function.
		Delirium may be caused by diseases of body systems other than the brain, by poisons, by fluid/electrolyte or acid/base disturbances, and by other serious, acute conditions.
		Delirium involves a rapid alternation between mental states (for example, from lethargy to agitation and back to lethargy), with attention disruption, disorganized thinking, disorientation, changes in sensation and perception, and other symptoms.
	www.nlm.nih.gov /medlineplus/ency/article/000740.htm (807 words)

	eMedicine - Delirium : Article by Kannayiram Alagiakrishnan, MD
		Delirium is defined as a transient, usually reversible, cause of cerebral dysfunction and manifests clinically with a wide range of neuropsychiatric abnormalities.
		Delirium often is unrecognized or misdiagnosed and commonly is mistaken for dementia, depression, mania, an acute schizophrenic reaction, or part of old age (patients who are elderly are expected to become confused in the hospital).
		Delirium is present in 10-22% of elderly patients at the time of admission, with an additional 10-30% of cases developing after admission.
	www.emedicine.com /med/topic3006.htm (4625 words)

	ABC of psychological medicine: Delirium -- Brown and Boyle 325 (7365): 644 -- BMJ (Site not responding. Last check: 2007-10-07)
		Delirium is a common cause of disturbed behaviour in medically ill people and is often undetected and poorly managed.
		Chronic alcoholics are at risk of Wernicke's encephalopathy, in which delirium becomes complicated by ataxia and ophthalmoplegia.
		delirium is associated with withdrawal from alcohol or sedatives.
	bmj.com /cgi/content/full/325/7365/644 (1986 words)

	Untitled Document (Site not responding. Last check: 2007-10-07)
		Abraham et al, showed that this agitated state is a large physiologic burden with increases in cardiac index of up to 36% and oxygen delivery and consumption of 25%.3 As this often occurs in concert with acute medical illness in patients with significant comorbidities, ICU monitoring is necessary.
		Delirium tremens is the consequence of complex interactions between multiple neurotransmitters and the up and down regulation of their receptor activity after chronic ethanol ingestion is interrupted.
		Gamma-aminobutyric acid (GABA), the main inhibitory transmitter, and glutamate, the predominant excitatory transmitter, are significantly influenced by chronic alcohol ingestion.5,6 GABA receptors are up regulated (leading to a relative GABA deficiency during ethanol withdrawal) and glutamate receptors are down regulated (resulting in a relative overabundance of glutamate during ethanol withdrawal).
	www.isccm.org /journals/july01/propofol.html (1886 words)

	Delirium -- Burns et al. 75 (3): 362 -- Journal of Neurology, Neurosurgery, and Psychiatry
		Delirium and confusion in the 19th century: a conceptual history.
		Delirium: the occurrence and persistence of among hospitalized elderly patients.
		The a9 allele of the dopamine transporter gene is associated with delirium tremens and alcohol-withdrawal seizure.
	jnnp.bmjjournals.com /cgi/content/full/75/3/362 (3225 words)

	Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomized trial -- Cole et ... (Site not responding. Last check: 2007-10-07)
		Delirium is a mental disorder characterized by acute onset,
		prevalence of delirium at admission was 12.6% (243/1925); the
		Acute delirium and functional decline in the hospitalized elderly patient.
	www.cmaj.ca /cgi/content/full/167/7/753 (3956 words)

	Regular review: Delirium: optimising management -- Meagher 322 (7279): 144 -- BMJ
		Delirium is a complex neuropsychiatric syndrome with an acute onset and fluctuating course; it is common in all medical settings.
		Delirium is underidentified in clinical practice: non-detection rates of 33-66% are typically reported.
		Delirium is caused by factors in the patient as well as by pharmacological and environmental factors (box).
	www.bmj.com /cgi/content/full/322/7279/144 (3550 words)

	Office of Public Affairs at Yale - News Release
		Delirium developed in only 9.9 percent of the intervention group, compared with 15 percent of the control group receiving routine care -- a 40 percent lower rate in matched analyses.
		None of the patients showed delirium upon admission, although they were categorized at either intermediate or high risk for developing delirium.
		The incidence of delirium is expected to increase with the aging of the population in coming years as baby boomers retire.
	www.yale.edu /opa/newsr/99-03-03-01.all.html (1231 words)

	A Predictive Model for Delirium in Hospitalized Elderly Medical Patients Based on Admission Characteristics -- Inouye ...
		factors for delirium in elderly, hospitalized patients [9,12,13,14,16,30,31].
		the incidence of delirium in an elderly hospitalized cohort
		Delirium: the occurrence and persistence of symptoms among elderly hospitalized patients.
	www.annals.org /cgi/content/full/119/6/474 (5388 words)

	Delirium: The story behind the story ...
		I was enchanted by her silliness, moved by her sadness, and disturbed by her unexplained past.
		Naturally, the character of Delirium and the names of the other Endless (Destiny, Dream, Death, Destruction, Desire, and Despair) are all © DC Comics.
		And as she put herself back together again, unable for the moment to remember whether the silver flecks went in the blue eye or the green one, she decided that a dog would be a nice thing to have.
	www.sff.net /people/karawynn/delirium.htp (1095 words)

	The Concord Delirium (Site not responding. Last check: 2007-10-07)
		Delirium Tremens: "That's what the product engineers at the Swiss movement company ETA called their frantic scramble to develop the world's thinnest watch, the Delirium.
		When they'd finished their work, in January 1979, they had something that must have inspired a few hangovers- a quartz watch that was a remarkable 1.98 mm thin.
		The last, called the Delirium IV, was an amazing.98mm thick, so delicate it could not be worn because the case would bend when you strapped the watch to your wrist.
	www.bidtheewell.com /whatsnew/concordarticle.html (358 words)

	Acute Delirium as a Manifestation of Obstructive Sleep Apnea Syndrome -- MUÑOZ et al. 158 (4): 1306 -- American ...
		Acute Delirium as a Manifestation of Obstructive Sleep Apnea Syndrome
		Delirium may be caused by a range of organic factors grouped into four general classes (5): (1) primary cerebral diseases,
		Inouye, S. The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients.
	www.ajrccm.org /cgi/content/full/158/4/1306 (1174 words)

	Practice Guidelines,PHARMACOLOGICAL MANAGEMENT OF ALCOHOL WITHDRAWAL: JAMA 1997 (Site not responding. Last check: 2007-10-07)
		This guideline does not address treatmentt of the patient who is examined after having an alcohol withdrawal seizure or who has already developed alcohol withdrawal delirium (delirium tremens), or the optimal setting for withdrawal management (inpatient or outpatient).
		Furthermore, delirium is a known side effect of beta blockers, particularly those with good central nervous system penetration such as propranolol.
		In one case report, the diagnosis of withdrawal delirium was significantly delayed in a patient who presented with marked confusion because the patient had earlier been placed on a regimen of propranolol and thus demonstrated none of the autonomic hyperactivity classically associated with alcohol withdrawal delirium.
	www.asam.org /publ/withdrawal.htm (6961 words)

	JAMA -- Abstract: Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit, ... (Site not responding. Last check: 2007-10-07)
		JAMA -- Abstract: Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit, April 14, 2004, Ely et al.
		Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit
		Conclusion Delirium was an independent predictor of higher
	jama.ama-assn.org /cgi/content/abstract/291/14/1753 (337 words)

	OUP: Delirium in Old Age: Lindesay
		Delirium is a cognitive disorder consisting of deficits of attention, arousal, consciousness, memory, orientation, perception, speech and language.
		Despite its importance in terms of clinical, economic and social considerations, and despite considerable advances in the past decade, it remains a relatively misunderstood and mis-diagnosed condition.
		This volume will serve as a catalyst to revive interest and progress in delirium research and clinical care, and should be read by psychiatrists, neurologists, geriatricians and all those involved in working with the elderly in hospitals or in the community.
	www.oup.co.uk /isbn/0-19-263275-2 (475 words)

	Delirium: the role of psychiatry -- Meagher 7 (6): 433 -- Advances in Psychiatric Treatment
		David Meagher was the 1998 Eli-Lilly Royal College of Psychiatrists Travelling Fellow and spent a sabbatical studying the neuropsychiatry of delirium with Paula Trzepacz at the University of Mississippi.
		Delirium is a complex neuropsychiatric syndrome that is common
		Wada, Y. and Yamaguchi, N. (1993) Delirium in the elderly: relationship of clinical symptoms to outcome.
	apt.rcpsych.org /cgi/content/full/7/6/433 (3601 words)

	AN OVERVIEW OF DELIRIUM Confused terminology (Site not responding. Last check: 2007-10-07)
		DSM-IV and ICD-10 characterise delirium as synonymous with acute brain failure.
		Delirium is not only the "florid confusion" of the popular Press (agitation, fear, complex delusions or hallucinations).
		It can sometimes be difficult to differentiate the subjective confusion occurring in psychotic illness from the objective changes of delirium - if in doubt, discuss with specialists.
	www.jr2.ox.ac.uk /geratol/dcdelir2.htm (670 words)

	Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomized trial -- Cole et ... (Site not responding. Last check: 2007-10-07)
		Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomized trial -- Cole et al.
		Systematic detection and multidisciplinary care of delirium in older medical inpatients: a randomized trial
		Delirium Index, the Barthel Index, length of stay, rate of discharge
	www.cmaj.ca /cgi/content/abstract/167/7/753 (746 words)

	JAMA -- Abstract: Delirium in Mechanically Ventilated Patients: Validity and Reliability of the Confusion Assessment ...
		JAMA -- Abstract: Delirium in Mechanically Ventilated Patients: Validity and Reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), December 5, 2001, Ely et al.
		diagnoses of delirium, stupor, and coma occurred in 25.2%, 21.3%,
		Delirium was even present in 39.5% of alert
	jama.ama-assn.org /cgi/content/abstract/286/21/2703 (578 words)

	Capacity, consent, and selection bias in a study of delirium -- Adamis et al. 31 (3): 137 -- Journal of Medical Ethics
		Capacity, consent, and selection bias in a study of delirium -- Adamis et al.
		Capacity, consent, and selection bias in a study of delirium
		influence the case mix of subjects recruited to a study of delirium.
	jme.bmjjournals.com /cgi/content/abstract/31/3/137 (329 words)

	The Mythic Delirium Home Page
		We at Mythic Delirium are honored to be able to include fantasy-themed poems from her 1981 collection, Hard Words, in upcoming issues 11 and 12.
		To commemorate five years of publication, we at Mythic Delirium have assembled a 16-page Free Sampler Issue, available in Adobe Acrobat PDF format, containing a sampling of some of the most memorable poems and illustrations from Issues 1 thru 9.
		Mythic Delirium is a biannual journal that publishes science fiction, fantasy, horror, surreal and cross-genre poetry.
	www.mythicdelirium.com (1345 words)

	Arch Intern Med -- Abstract: Nurses' Recognition of Delirium and Its Symptoms: Comparison of Nurse and Researcher ...
		Arch Intern Med -- Abstract: Nurses' Recognition of Delirium and Its Symptoms: Comparison of Nurse and Researcher Ratings, November 12, 2001, Inouye et al.
		were because of underrecognition of delirium by the nurses.
		Delirium Superimposed on Dementia in a Community-Dwelling Managed Care Population: A 3-Year Retrospective Study of Occurrence, Costs, and Utilization
	archinte.ama-assn.org /cgi/content/abstract/161/20/2467 (475 words)

	- Google Scholar
		Results 1 - 7 of 7 citing Aldemir: Predisposing factors for delirium in the surgical intensive care unit.
		The impact of delirium on the survival of mechanically ventilated patients
		November 2004, 32:11 > The impact of delirium on the survival...
	www.biomedcentral.com /pubmed/gs/11737901 (291 words)

	JAMA -- Abstract: A prospective study of delirium in hospitalized elderly, February 23, 1990, Francis et al. 263 (8): ...
		JAMA -- Abstract: A prospective study of delirium in hospitalized elderly, February 23, 1990, Francis et al.
		The prevalence, risk factors, and outcomes of delirium were studied in 229
		Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study
	dx.doi.org /10.1001/jama.263.8.1097 (597 words)

	Treatment of Delirium in Older Adults with Quetiapine -- Kim et al. 16 (1): 29 -- Journal of Geriatric Psychiatry and ...
		Treatment of Delirium in Older Adults with Quetiapine -- Kim et al.
		Delirium is a neuropsychiatric syndrome characterized by impairment
		In addition, delirium is often accompanied by delusions, hallucinations,
	jgp.sagepub.com /cgi/content/abstract/16/1/29 (302 words)

	Arch Intern Med -- Abstract: Delirium Predicts 12-Month Mortality, February 25, 2002, McCusker et al. 162 (4): 457
		Background Delirium has not been found to be a significant
		The effect of delirium was sustained over the entire 12-month
		was a weak, nonsignificant effect of delirium on survival.
	archinte.ama-assn.org /cgi/content/abstract/162/4/457 (348 words)

	Recorded Delirium in a National Sample of Elderly Inpatients: Potential Implications for Recognition -- Kales et al. 16 ...
		Recorded Delirium in a National Sample of Elderly Inpatients: Potential Implications for Recognition -- Kales et al.
		Articles by Kales, H. Articles by Blow, F. Recorded Delirium in a National Sample of Elderly Inpatients: Potential Implications for Recognition
		of delirium may be more commonly diagnosed and recorded.
	jgp.sagepub.com /cgi/content/abstract/16/1/32 (306 words)

	Delirium: Main Page (Site not responding. Last check: 2007-10-07)
		The first thing is a new release of the Delirium screen saver which, while there are no new savers, does have at least one worthwhile new feature.
		This is the first release of Delirium that we have decided to make freeware.
		Delirium is free to download and to use.
	www.kulture.org.uk (360 words)

	JAMA -- Abstract: Risk factors for delirium in hospitalized elderly, February 12, 1992, Schor et al. 267 (6): 827
		JAMA -- Abstract: Risk factors for delirium in hospitalized elderly, February 12, 1992, Schor et al.
		Delirium on Hospital Admission in Aged Hip Fracture Patients: Prediction of Mortality and 2-Year Functional Outcomes
		Hypoactive Delirium as a Clinical Symptom of Intestinal Perforation
	dx.doi.org /10.1001/jama.267.6.827 (466 words)

	Acute Delirium (Site not responding. Last check: 2007-10-07)
		Symptoms tend to fluctuate in intensity, with periods of relative lucidity interspersed with periods of severe impairment.
		Haloperidol can be given PO, IM, IV, has minimal effects on hemodynamic and respiratory function and is unlikely to cause or aggravate delirium.
		Dementia and delirium with associated psychotic and/or agitated behaviors that
	neuroland.com /psy/delirium.htm (468 words)

	Anesthesia, the aging brain, and the surgical patient -- Crosby and Culley 50 (Supplement 1): 12 -- Canadian Journal of ...
		Delirium, defined as acute disturbance in consciousness and
		Post-operative delirium: predictors and prognosis in elderly orthopedic patients.
		Reducing delirium after hip fracture: a randomized trial.
	www.cja-jca.org /cgi/content/full/50/suppl_1/R12 (2508 words)

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