scholarly journals Emergence Delirium in a 29-Year-Old Man following an Uneventful Appendectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Zhi Wang ◽  
Yong Yang ◽  
Yang Chen ◽  
Kai Lu ◽  
Bing Chen
Keyword(s):  
Young Adults ◽  
Elderly Patients ◽  
Mental Stress ◽  
Precipitating Factors ◽  
Sleep State ◽  
Predisposing Factor ◽  
Emergence Delirium ◽  
Healthy Man ◽  
Minor Surgery ◽  
Precipitating Factor

Emergence delirium (ED) is defined as the delirium that occurs during the transition from the sleep state to full consciousness. ED increases the risk for injury, self-extubation, hemorrhages, and prolonged hospitalization and occurs in patients of any age but most often in children and elderly patients. However, ED in young adults is rarely reported. We presented a case of typical ED occurring in a young healthy man following an uneventful appendectomy. The causes of ED can be classified as either predisposing or precipitating factors. In this case, the unnoticeable mental stress may be the predisposing factor and the sevoflurane maintenance of anesthesia may be the precipitating factor. ED occurs at any age of patient and in any minor surgery, and anesthesiologists should do some work to prevent it from happening.

106 Precipitating factors in the elderly patients admitted with the diagnosis of heart failure. Are easy to find?

2006 ◽  
Vol 5 (1) ◽  
pp. 25-26
Author(s):  
R VIDALPEREZ ◽  
E ABUASSI ◽  
M PARAMODEVEGA ◽  
P VELOSO ◽  
A VARELAROMAN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
The Elderly ◽  
Precipitating Factors

scholarly journals Precipitating factors of porphyria cutanea tarda in Brazil with emphasis on hemochromatosis gene (HFE) mutations. Study of 60 patients

2013 ◽  
Vol 88 (4) ◽  
pp. 530-540 ◽  
Author(s):  
Fatima Mendonca Jorge Vieira ◽  
Maria Cristina Nakhle ◽  
Clarice Pires Abrantes-Lemos ◽  
Eduardo Luiz Rachid Cancado ◽  
Vitor Manoel Silva dos Reis
Keyword(s):  
Hepatitis C ◽  
Alcohol Abuse ◽  
Porphyria Cutanea Tarda ◽  
Hereditary Hemochromatosis ◽  
Control Group ◽  
Hfe Gene ◽  
Precipitating Factors ◽  
Serological Tests ◽  
Hfe Mutations ◽  
Precipitating Factor

BACKGROUND: Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. OBJECTIVES: Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. METHODS: An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. RESULTS: Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. CONCLUSIONS: Alcohol abuse, hepatitis C and estrogen intake are prevalent precipitating factors in our porphyria cutanea tarda population; however, hemochromatosis in itself can also contribute to the outbreak of porphyria cutanea tarda, which makes the research for HFE mutations necessary in these patients

scholarly journals Malnutrition Was Not Related With Emergence Delirium in Elderly Patients After Noncardiac Surgery

2021 ◽  
Author(s):  
Fang Zhang ◽  
Shu-Ting He ◽  
Yan Zhang ◽  
Dong-Liang Mu ◽  
Dong-Xin Wang
Keyword(s):  
Elderly Patients ◽  
Multivariable Analysis ◽  
Noncardiac Surgery ◽  
Nutritional Risk ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Emergence Delirium ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
The Relationship

Abstract Background: Delirium is one of the most common complications in elderly surgical patients. Although previous studies reported that preoperative malnutrition was related with postoperative delirium (POD), there was lack of evidence to illustrate the relationship between malnutrition and emergency delirium (ED). The objective of this study was to investigate the relationship between preoperative malnutrition and ED in elderly patients undergoing noncardiac surgery.Methods: The study was carried out in accordance with STROBE guidelines. This was a secondary analysis of a prospective cohort study. Elderly patients (65-90 years) who underwent noncardiac surgery under general anesthesia were enrolled in Peking University First Hospital.Preoperative malnutrition was defined as nutritional risk screening 2002 (NRS 2002) ≥3. Emergence delirium was assessed by Confusion Assessment Method for intensive care unit at 10 and 30 min after Post-anesthesia care unit (PACU) admission, and before PACU discharge. Multivariable analysis was employed to analyze the relationship between malnutrition and emergence delirium.Results: 915 patients were enrolled. The incidence of malnutrition was 53.6% (490/915). The incidence of emergency delirium was 41.8% (205/490) in malnutrition group and 31.5% (134/425) in control group, P<0.001. After adjusting confounding factors (i.e., age, mild cognitive impairment, American Society of Anesthesiologists classification (ASA), duration of surgery, pain score, low body temperature and allogeneic blood transfusion), malnutrition was not associated with increased risk of emergency delirium (OR=1.055, 95% CI 0.767-1.452, P=0.742).Conclusions: Malnutrition was common in elderly patients undergoing non-cardiac surgery, but it’s not related with emergence delirium after adjusted for confounders.Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn) (Number: ChiCTR-OOC-17012734).

scholarly journals Prevalence and Precipitating Factors of Migraine in Secondary School Students in Thailand

2018 ◽  
Vol 08 (01) ◽  
pp. e50-e54
Author(s):  
Vitchayaporn Saengow ◽  
Sirikarn Tangcheewinsirikul
Keyword(s):  
Primary Headache ◽  
Common Disease ◽  
Baseline Characteristic ◽  
Precipitating Factors ◽  
School Students ◽  
Cross Sectional ◽  
School Based ◽  
Precipitating Factor

Introduction Migraine is the most common primary headache in children which leads to disturbance of school performance and impaired quality of life. The prevalence of migraine is different between countries and ethnicities; this study determines the prevalence and precipitating factors of migraine in Thailand. Method This cross-sectional school-based study was conducted in Nakhon Ratchasima. The children aged between 12 and 18 years from four secondary schools were selected by stratified randomization method. The screening questionnaire and directed interview with physical examination were done and migraine was diagnosed based on the criteria of International Classification of Headache Disorders III. The prevalence of migraine was identified and baseline characteristic of disease with precipitating factors was evaluated. Results A total of 2,744 students aged between 12 and 18 years (900 males, 1,844 females) were recruited; mean age was 14.3 ± 1.75 years. Fifty-five students were diagnosed with migraine (20 males [36.36%], 35 females [63.64%], mean age: 15.1 ± 1.6 years). The prevalence of migraine was 1.98%. Migraine prevalence was predominant in female adolescents with a common feature being migraine without aura. The important precipitating factor in this study was stress from academic achievement. Conclusion Migraine is a common disease in children and under-recognized in school students, and stress is the major precipitating factor.

How Does Age Impact Presentation and Outcomes in Chronic Rhinosinusitis?

2020 ◽  
Vol 129 (9) ◽  
pp. 872-877
Author(s):  
Thomas Holmes ◽  
Chadi Makary ◽  
Aykut A. Unsal ◽  
Paul Biddinger ◽  
Camilo Reyes-Gelves ◽  
...  
Keyword(s):  
Young Adults ◽  
Elderly Patients ◽  
Chronic Rhinosinusitis ◽  
Statistical Difference ◽  
Prognostic Indicators ◽  
Level Of Evidence ◽  
Tissue Eosinophilia ◽  
Short And Long Term ◽  
Snot 22

Objectives/Hypothesis: The presence of eosinophilia and nasal polyps are well-established prognostic indicators of chronic rhinosinusitis (CRS). The importance of demographic background, such as age, as independent variables has not been elucidated while taking these factors into account. Study Design: Respective review. Methods: CRS patients who underwent primary surgical treatment were subdivided based on age (young adults = age 18-39, adults = age 40-64, and elderly = age 65+). Groups were then subdivided based on tissue eosinophilia and nasal polyposis. Sinonasal Outcome Test (SNOT-22), Lund-Kennedy (LK) endoscopy scores, and Lund-McKay (LM) CT scores were compared preoperatively, and postoperatively during a 5-year period. Results: A total of 431 CRS patients identified and then subsequently broken down into 63 young adults (YA), 209 adults (A), and 159 elderly (E). There was no statistical difference between tissue eosinophilia and presence of polyps between the groups. All three groups had similar short- and long-term SNOT-22 patterns postoperatively. At presentation, young adults had significantly higher SNOT-22 score (33.2 YA, 25.3 A, 23.5 E, P = .029) and significantly higher rhinologic scores (1.9 YA, 1.3 A, 1.3 E, P = .0012) than the adult and elderly patients. Objective disease severity using LK endoscopy scores were only significantly higher in young adults at 1-year time ( P = .0026). There was no statistical difference between the groups in regards to preoperative LM CT scores. Conclusions: Young adults are more likely to present with overall higher subjective SNOT-22 scores over adults and elderly patients, despite similar objective findings in the groups. Short- and long-term postoperative improvement holds across all age groups. Level of Evidence: 4

scholarly journals Effect of Montelukast 10 mg in Elderly Patients with Mild and Moderate Asthma Compared with Young Adults. Results of a Cohort Study

2018 ◽  
Vol 12 (1) ◽  
pp. 67-74
Author(s):  
Guillermo Sánchez ◽  
Diana Buitrago
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cohort Study ◽  
Elderly Patients ◽  
Inhaled Corticosteroids ◽  
Age Groups ◽  
The Elderly ◽  
Moderate Asthma ◽  
Beta 2

Background: The clinical characteristics and physio-pathogenic mechanisms of asthma in patients older than 60 years appear to differ from the behavior described for other age groups. Therefore, the effectiveness of medications for elderly patients with asthma should not be extrapolated from studies conducted on teenagers or young adults. Objective: The study aimed to establish the clinical effect of montelukast 10 mg in elderly patients with mild and moderate asthma compared to its effect on young adults. Method: A prospective cohort study was conducted during 12 weeks of follow-up, which consecutively included the total population of adult patients attended by a group of 21 general practitioners, between July and December 2016. Young adults (18-59 years) and older adults were included (60 years or older) with mild or moderate asthma, which, according to the criteria of his treating physician, had been prescribed montelukast 10 mg/day. The variables of interest were: use of inhaled corticosteroids during the last month, use of inhaled beta-2 adrenergic agonists as a rescue in the last month, having attended the emergency service during the last month due to an asthma attack, presence of wheezing in the physical examination, the number of attacks in the last month and the number of days without symptoms in the last month. Results: A total of 126 patients entered the cohort and 104 completed the follow-up, of which 29% were older adults. On admission, 65.4% of patients (68/104) had used rescue inhaled beta2 in the last month and had been using schemes with corticosteroids. After 12 weeks of follow-up, 58.1% (43/74) of the young adults required treatment schedules with corticosteroids, while in the elderly, only 36.7% of the patients (11/30) required this treatment scheme (p-value: 0.047). Regarding the use of rescue inhaled beta-2 at 12 weeks, 55% of young adults reported using them, compared to 33.3% of older adults (p-value: 0.041). Conclusion: In this cohort of patients, treated with montelukast 10 mg/day for 12 weeks, there was a reduction of broncho-obstructive symptoms and exacerbations of the disease. In older adults compared to young adults, a greater reduction in the use of beta2 agonists rescue medications and in the concomitant use of inhaled corticosteroid schemes was documented.

scholarly journals Hepatic Encephalopathy in Liver Cirrhosis: Precipitating factor and Outcome

2019 ◽  
Vol 17 (1) ◽  
pp. 2-4
Author(s):  
Dipendra Khadka ◽  
Dipendra Khadka ◽  
Anil Shrestha ◽  
S. D. Bassi ◽  
Binus Bhandari
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Hospital Stay ◽  
Early Recognition ◽  
Wide Spectrum ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Precipitating Factors ◽  
Cross Sectional ◽  
Precipitating Factor

Introduction: Hepatic encephalopathy, one of the major decompensating events of liver cirrhosis manifest as a wide spectrum of neurological or psychiatric abnormalities ranging from subclinical alterations to coma. The main aim of this study was to determine precipitants of hepatic encephalopathy (HE) and their impact on hospital stay and mortality. Methods: A hospital based cross-sectional study carried out in the Department of Medicine, Nepalgunj Medical College, Kohalpur from September 2018 to May 2019. Patients of liver cirrhosis with signs and symptoms of hepatic encephalopathy (HE) were enrolled in the study. Detailed history was taken with patients or patient's visitor regarding precipitating factors. Child Turcotte Pugh (CTP) class was used for assessing liver disease severity and West Haven classification was used for grading of hepatic encephalopathy. Results: Total patients of hepatic encephalopathy studied were 150. Among which, 114 (76%) were male and 36 (24%) were female. Mean age was 45 ± 11years. Common precipitating factors for hepatic encephalopathy identified were constipation 25.3%, Upper gastrointestinal bleed (9.3%), Spontaneous bacterial peritonitis (8%). No identifiable factor was observed in 6.7% cases. Significant relationship was noted with CTP class and grading of Hepatic encephalopathy. Hospital stay was also found longer (≥5 days) among patients having more than one precipitating factor. Conclusions: Early recognition of precipitants and patient education is very crucial in the management of hepatic encephalopathy. Patients having ≥ 2 precipitating factor had longer hospital stay and higher grade of hepatic encephalopathy.

A Study of the Sexual Life in Psychoses Associated with Childbirth

1933 ◽  
Vol 79 (324) ◽  
pp. 137-149 ◽  
Author(s):  
E. W. Anderson
Keyword(s):  
Mental Disorder ◽  
A Priori ◽  
Sexual Life ◽  
Precipitating Factors ◽  
Puerperal Depression ◽  
Precipitating Factor ◽  
As If

It is now universally recognized that there is nothing specific in the form of psychoses associated with childbearing. There is, however, still a tendency to attribute to the puerperium itself or to pregnancy or lactation a significance quite out of proportion to that of other precipitating factors; thus such terms as “puerperal depression”, or “puerperal schizophrenia” are still in use, as if the precipitating factor were something special as opposed to the innumerable other causes assigned to the appearance of an attack of mental disorder. Nor is this surprising when one reflects on the enormous significance of the sexual life. One is quite willing ona priorigrounds to grant to the puerperium this all-important rôle.

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