scholarly journals Severe, Persistent and Fatal Delirium in Psychogeriatric Patients Admitted to a Psychiatric Hospital

2015 ◽  
Vol 5 (2) ◽  
pp. 253-264 ◽  
Author(s):  
Ingrid S. Jans ◽  
Letty Oudewortel ◽  
Paulien M. Brandt ◽  
Willem A. van Gool
Keyword(s):  
Cognitive Impairment ◽  
Medical Records ◽  
Dementia With Lewy Bodies ◽  
Fatal Outcome ◽  
Case Series ◽  
Lewy Bodies ◽  
Inclusion Criteria ◽  
Disease Trajectory ◽  
History Of ◽  
Jakob Disease

Background/Aims: Although delirium is generally regarded as a transient syndrome, persistence of delirium in patients with cognitive impairment - even with fatal outcome - has been reported as well. This study aims to describe the clinical features and neuropathological correlates of this type of delirium. Methods: Inclusion criteria for this case series were: (1) severe persistent delirium until death, (2) history of cognitive decline and (3) consent for brain autopsy. Medical records were examined in combination with collected clinical data and neuropathological findings. Result: In 15 patients, all living at home before admission, episodes with delirium lasted for 4.2 months on average. No distinct medical causes of persistent delirium could be identified. Pathological diagnoses included Alzheimer's disease and dementia with Lewy bodies as well as single cases of Creutzfeldt-Jakob disease and progressive supranuclear palsy. Conclusion: Severe, persistent and fatal delirium in patients with cognitive impairment can occur relatively early in the disease trajectory and is associated with diverse neuropathologies.

Dementia with Lewy bodies

2020 ◽  
pp. 424-434
Author(s):  
Anto P. Rajkumar ◽  
Dag Aarsland
Keyword(s):  
Cognitive Impairment ◽  
Dementia With Lewy Bodies ◽  
Neuropsychiatric Symptoms ◽  
Clinical Manifestations ◽  
Lewy Bodies ◽  
Current Evidence ◽  
Future Research ◽  
Pharmacological Interventions ◽  
Neurodegenerative Dementia ◽  
History Of

Lewy bodies are eosinophilic spherical neuronal intracytoplasmic inclusions. Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia. Clinical manifestations of DLB include cognitive impairment, extra-pyramidal symptoms, neuropsychiatric symptoms, and autonomic dysfunction. Studies investigating the epidemiology, pathophysiology, clinical diagnosis, and management of DLB have been exponentially increasing over the past two decades. This chapter begins with a brief history of DLB and its epidemiology. It provides an overview of the pathology of DLB, focusing on its neuropathology, neuroimaging, molecular biology, and genetics. The clinical presentation, diagnosis, differential diagnoses, and clinical course of DLB are presented. This chapter summarizes the current evidence for the pharmacological and non-pharmacological interventions of cognitive, neuropsychiatric, and other symptoms of DLB. Future research directives are highlighted at the end of this chapter.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

Generalized Rhythmic Delta Activity Frontally Predominant Differentiates Dementia With Lewy Bodies From Alzheimer's Disease and Parkinson's Disease Dementia: A Conventional Electroencephalography Visual Analysis

2021 ◽  
pp. 155005942199714
Author(s):  
Lucia Zinno ◽  
Anna Negrotti ◽  
Chiara Falzoi ◽  
Giovanni Messa ◽  
Matteo Goldoni ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Dementia With Lewy Bodies ◽  
Visual Analysis ◽  
Lewy Bodies ◽  
Delta Activity ◽  
Rhythmic Delta Activity

Introduction. An easily accessible and inexpensive neurophysiological technique such as conventional electroencephalography may provide an accurate and generally applicable biomarker capable of differentiating dementia with Lewy bodies (DLB) from Alzheimer’s disease (AD) and Parkinson’s disease-associated dementia (PDD). Method. We carried out a retrospective visual analysis of resting-state electroencephalography (EEG) recording of 22 patients with a clinical diagnosis of 19 probable and 3 possible DLB, 22 patients with probable AD and 21 with PDD, matched for age, duration, and severity of cognitive impairment. Results. By using the grand total EEG scoring method, the total score and generalized rhythmic delta activity frontally predominant (GRDAfp) alone or, even better, coupled with a slowing of frequency of background activity (FBA) and its reduced reactivity differentiated DLB from AD at an individual level with an high accuracy similar to that obtained with quantitative EEG (qEEG). GRDAfp alone could also differentiate DLB from PDD with a similar level of diagnostic accuracy. AD differed from PDD only for a slowing of FBA. The duration and severity of cognitive impairment did not differ between DLB patients with and without GRDAfp, indicating that this abnormal EEG pattern should not be regarded as a disease progression marker. Conclusions. The findings of this investigation revalorize the role of conventional EEG in the diagnostic workup of degenerative dementias suggesting the potential inclusion of GRDAfp alone or better coupled with the slowing of FBA and its reduced reactivity, in the list of supportive diagnostic biomarkers of DLB.

Characterization of dementia with Lewy bodies (DLB) and mild cognitive impairment using the Lewy body dementia module (LBD‐MOD)

2021 ◽  
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Iris Cohen ◽  
Keri K. Greenfield ◽  
Michael J. Kleiman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lewy Body ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Lewy Body Dementia

scholarly journals Childhood Pilomatrixoma: Case Series from a Single Center

2020 ◽  
Author(s):  
Begümhan Demir Gündoğan ◽  
Fatih Sağcan ◽  
Mehmet Alakaya ◽  
Ferah Tuncel Daloğlu ◽  
Elvan Çağlar Çıtak
Keyword(s):  
Differential Diagnosis ◽  
Medical Records ◽  
Clinical Presentation ◽  
Case Series ◽  
Neck Region ◽  
Head And Neck Region ◽  
Common Causes ◽  
Institutional Experience ◽  
History Of ◽  
Associated Conditions

INTRODUCTION: The aim of this study is to describe our institutional experience with pilomatrixoma in children, specifically examining its clinical presentation, associated conditions, radiological and pathological findings and attract attention to differential diagnosis for this tumor. METHODS: The medical records of 52 patients were reviewed retrospectively. RESULTS: There were a total of 62 tumors in 52 children. The median age at excision was 9.5 years old. Tumors were predominantly located in head and neck region (48.4%). One patient had a family history of pilomatrixoma. One patient had Turner Syndrome and one had Tuberous Sclerosis complex. Fifty-four lesions were examined by ultrasonography (USG). Pilomatrixoma was considered in the differential diagnosis in eight patients (15.3%) by a radiologist. DISCUSSION AND CONCLUSION: Pilomatrixoma is one of the most common causes of superficial masses in children. It should be kept in mind for differential diagnosis in children with superficial masses.

INSULAR COGNITIVE IMPAIRMENT IN EARLY DEMENTIA WITH LEWY BODIES

2017 ◽  
Vol 13 (7) ◽  
pp. P1462
Author(s):  
Anne Botzung ◽  
Nathalie Philippi ◽  
Morgane Constans-Erbs ◽  
Jennifer Kemp ◽  
Malik Hamdaoui ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Early Dementia

The Rationality of Using Diclofenac in Outpatient Cases of Osteoarthritis of RSUP MH Palembang Period January-March 2018

2021 ◽  
Vol 2 (1) ◽  
pp. 43-50
Author(s):  
Dara Prameswari ◽  
Nita Parisa ◽  
Muhammad Totong Kamaluddin
Keyword(s):  
Side Effects ◽  
Medical Records ◽  
Daily Activity ◽  
Sampling Technique ◽  
Synergistic Interaction ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Correct Dose ◽  
History Of ◽  
Lowback Pain

Rationality of Diclofenac Use in Osteoarthritis Outpatient Case at RSUP MHPalembang in January-March 2018. Osteoarthritis (OA) is the most common diseasein joints that affects people in their middle until late years. In Indonesia the prevalenceof OA is relatively high and disturbs their daily activity. Diclofenac is one of the drug ofchoice in treating OA. To avoid multiple side effects from Diclofenac use, the usagemust be in accordance to rationality indicators which are correct dose, correctfrequency, and correct length of use. This study is aimed to know the rationality ofDiclofenac use in Osteoarthritis outpatient cases at RSUP Mohammad HoesinPalembang. This study is a descriptive observational with a cross-sectional approachto know the rationality of Diclofenac use in outpatient cases of osteoarthritis at RSUPMohammad Hoesin Palembang. Samples were medical records of OA patients inoutpatient setting from January to March 2018 which fulfilled the inclusion andexclusion criteria. Sampling technique used was total sampling. The amount ofsamples fulfilling the inclusion criteria were 201 patients, with the most were aged 46-65 years (60.2%), female (55.7%), and has a history of comorbidity which includes lowback pain (22.8%). The result of this study shows pattern of Diclofenac use with dosageof 2 x 25mg (73.6%), length of use about <7 days (57.2%). In combination with otherdrugs there were no interaction to be found (84.4%), or synergistic interaction (8.5%)and antagonistic interaction (7.1%). The use of diclofenac in osteoarthritis cases atoutpatient setting in RSUP Dr Mohammad Hoesin Palembang is rational and needs tobe maintained.

Clinical Aspects of Non-Alzheimer Disease Dementias

2017 ◽  
Author(s):  
David Knopman
Keyword(s):  
Cognitive Impairment ◽  
Alzheimer Disease ◽  
Cerebrovascular Disease ◽  
Lewy Body ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Lewy Body Disease ◽  
Clinical Aspects ◽  
Key Words Dementia ◽  
Sleep Behavior

There are a relatively small number of disorders that account for the majority of dementia in the elderly that is not Alzheimer disease (AD): cerebrovascular disease, Lewy body disease (α-synucleinopathies), and the frontotemporal lobar degenerations. Cerebrovascular disease and Lewy body disease account for most non-AD dementia among persons in the eighth decade of life and beyond. These two frequently co-occur with AD but can occur in their pure forms rarely (in the case of dementia associated with cerebrovascular disease) or more commonly (in the case of Lewy body disease). There is no one cognitive or behavioral syndrome associated with cerebrovascular disease; however, attempts to isolate a common theme suggest that cognitive slowing is typical of cerebrovascular contributions to cognitive impairment. Cerebrovascular pathology relevant to cognitive impairment accumulates subclinically more commonly than it causes acute, strokelike declines in cognition. Dementia with Lewy bodies is a multidimensional disorder that includes a nonamnestic dementia, Parkinson disease or at least some parkinsonian features, a disorder of sleep and wakefulness, autonomic disturbances, and depression. The disorders of sleep prominently include rapid eye movement sleep behavior disorder, excessive daytime sleepiness, visual hallucinations, and marked fluctuations in level of alertness. The frontotemporal lobar degenerations are nearly as common as causes of dementia in persons under age 65 as is AD. The group of disorders includes two cognitive syndromes (primary progressive aphasia and behavior variant frontotemporal dementia) and two neuropathologic subtypes (tauopathy and TDP43 proteinopathy) and is associated with three major autosomal dominant genetic mutations (in MAPT, GRN, and C9ORF72). Key words: dementia with Lewy bodies, frontotemporal lobar degenerations, vascular cognitive impairment

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