The association of the dopamine transporter gene and the dopamine receptor 2 gene with delirium, a meta-analysis.

Delirium is the most common neuropsychiatric syndrome in elderly ill patients. Previously, associations between delirium and the dopamine transporter gene (solute carrier family 6, member 3 (SLC6A3)) and dopamine receptor 2 gene (DRD2) were found. The aim of this study was to validate whether markers of the SLC6A3 and DRD2 genes are were associated with delirium in independent populations.

The role of genetics in delirium in the elderly patient.

Delirium is an important neuropsychiatric syndrome in the elderly that is associated with an increase in mortality, impaired physical and cognitive recovery, and increased healthcare costs. Two important gaps in daily practice with delirium are the pathophysiological obscurity and the low recognition rates. Genetics offers the possibility to contribute knowledge to both of these gaps with its unique and diverse techniques.

Serum S100B in elderly patients with and without delirium.

Objective: Elevation of S100B has been shown after various neurologic diseases with cognitive dysfunction. The aim of this study was to compare the serum level of S100B of patients with and without delirium and investigate the possible associations with different subtypes of delirium.

Methods: Acutely admitted medical patients aged 65 years or more were included from 2005 through 2008.

Markers of cerebral damage during delirium in elderly patients with hip fracture.

Background: S100B protein and Neuron Specific Enolase (NSE) can increase due to brain cell damage and/or increased permeability of the blood-brain-barrier. Elevation of these proteins has been shown after various neurological diseases with cognitive dysfunction. Delirium is characterized by temporal cognitive deficits and is an important risk factor for dementia.

Genetic polymorphisms in the DRD2, DRD3, and SLC6A3 gene in elderly patients with delirium.

Dopamine excess appears to be critical in the final common pathway of delirium. The aim of this study was to investigate whether genetic polymorphisms in three dopamine-related genes (the dopamine receptor 2 (DRD2), dopamine receptor 3 (DRD3), and the dopamine transporter (SLC6A3) gene) were associated with delirium. Patients aged 65 years and older acutely admitted to the medical department or to the surgical department following hip fracture were included.

The genetics of deliria.

Delirium not induced by alcohol or other psychoactive substance and alcohol withdrawal delirium (or delirium tremens) are both cerebral syndromes with similar presentations and are associated with various adverse outcomes. Recently, interest in identifying genetic predisposing factors that influence the occurrence or the outcome of delirium has become a prominent point of delirium research. We systematically searched published articles concerning genetic associations and the occurrence and outcome of delirium.

Prognostication in acutely admitted older patients by nurses and physicians.

Background: The process of prognostication has not been described for acutely hospitalized older patients.

Objective: To investigate (1) which factors are associated with 90-day mortality risk in a group of acutely hospitalized older medical patients, and (2) whether adding a clinical impression score of nurses or physicians improves the discriminatory ability of mortality prediction.

Design: Prospective cohort study.

Time-course of cytokines during delirium in elderly patients with hip fractures.

Objectives: To compare the time-course of cytokine levels in patients with and without delirium and investigate differences in cytokine concentrations in delirium subtypes.

Design: Prospective cohort study.

Setting: Academic Medical Center, Amsterdam, 2005 through 2007.

[Co-morbidity in acutely hospitalised older patients as a risk factor for death in hospital or within 3 months after discharge].

Objective: To study the presence of co-morbidity and delirium and to determine whether these factors are predictors of hospital and shortterm mortality in elderly patients acutely admitted to a department of internal medicine.

Design: Prospective cohort study.

Method: Social and demographic data as well as data on their physical and cognitive limitations were collected from consecutive patients of 65 years and older who were hospitalised in the period from I December 2002 to 30 June 2005 in the Academic Medical Centre in Amsterdam, the Netherlands.

[Society, economy, inequities and dengue].

Dengue and dengue hemorrhagic fever in the Americas have been on the rise throughout the 1990s, with the highest number -over one million cases- reported in 2002. This paper analyzed the situation of dengue in the region and discussed the determining factors that account for the rise of the disease, making emphasis on socioeconomic factors, such as poverty, inequality, migrations and the lack of access to basic services, which are the most influential in perpetuating this disease in most countries. Considering that a safe and accessible vaccine is now unavailable, basic principles of vector control combined with political willingness, inter-sectoral involvement, active community participation and the tightening of health legislation were also examined as the only viable solution at present.

The association between delirium and the apolipoprotein E epsilon4 allele in the elderly.

Objective: As not all patients with similar risk factors and eliciting conditions develop delirium; it may be hypothesized that genetic variation may play a role in the risk of delirium. On the basis of the relationship between dementia, respectively reduced cholinergic activity, and the APOE epsilon4-allele, and the similarities between dementia and delirium in reduced cholinergic activity, the APOE epsilon4-allele is a rational candidate-gene for delirium. This study examined the association between APOE epsilon4-allele and delirium in elderly patients.

Cytokines and acute phase response in delirium.

Objective: This study aimed to examine the expression patterns of pro- and anti-inflammatory cytokines in elderly patients with and without delirium who were acutely admitted to the hospital.

Methods: All consecutive patients aged 65 years and older, who were acutely admitted to the Department of Internal Medicine of the Academic Medical Center, Amsterdam, a tertiary university teaching hospital, were invited. Members of the geriatric consultation team completed a multidisciplinary evaluation for all study participants within 48 h after admission, including cognitive and functional examination by validated measures of delirium, memory, and executive function.

Genetic polymorphisms related to delirium tremens: a systematic review.

Background: Delirium tremens (DT) is one of the more severe complications of alcohol withdrawal (AW), with a 5 to 10% lifetime risk for alcohol-dependent patients. The 2 most important neurosystems involved in AW are gamma-aminobutyric acid and glutamate. It is unknown whether these neurosystems are involved in the pathophysiology of DT as well.

Delirium subtype identification and the validation of the Delirium Rating Scale--Revised-98 (Dutch version) in hospitalized elderly patients.

Background: Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. The Dutch version of the Delirium Rating Scale-Revised-98 (DRS-R-98) appears to be a reliable method to classify delirium. The aim of this study was to determine the validity and reliability of the DRS-R-98 and to study clinical subtypes of delirium using the DRS-R-98.

Risk factors for delirium in acutely admitted elderly patients: a prospective cohort study.

Background: Delirium is a neuropsychiatric syndrome frequently observed in elderly hospitalised patients and can be found in any medical condition. Due to the severe consequences, early recognition of delirium is important in order to start treatment in time. Despite the high incidence rate, the occurrence of delirium is not always identified as such.

Cystic dilatation of the common bile duct: surgical treatment and long-term results.

Twelve patients (11 female) with an extrahepatic biliary cyst (six type I, three type II and three type III according to the classification of Todani) are reviewed with emphasis on aetiology, clinical features and long-term results at follow-up of 3-10 years. The clinical manifestations were abdominal pain, cholestasis with jaundice, fever and episodes of pancreatitis. The diagnosis was established before surgery in all cases by ultrasonography, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography and computed tomography.

[Anomaly of the pancreatico-biliary junction and etiology of choledochal cysts].

The etiology of choledochal cysts isn't yet clarified unequivocably. Numerous theories have been worked out. One of them is the 1969 by Babbitt postulated "common-channel"-theory, which is based on an anomaly of the pancreaticobiliary connection.

[Diagnosis and surgical therapy in congenital ectasias of the intra- and extrahepatic bile ducts].

31 patients with congenital ectasias of extra- and intrahepatic bile ducts have been diagnosed and treated between 1980 and 1991 at the Charité. 7 ectasias belonged to type I, two to type II, three to type III, four to type IV and fifteen to type V of classification by Alonso-Lej/Todani. The age of affection was between 8 and 80 years.

[Changing trends in percutaneous and endoscopic bile duct drainage].

Analysis of 1,104 non-surgical biliary drainages (600 ERCD, 531 PTCD) from 1983 to 1988 concerning changing frequency, indications and success rates. With a continuous increase of the total numbers, the fraction of percutaneous-transhepatic drainages has decreased to 28%. With increasing degree of difficulty and risk PTCD (90.

[Endoscopic-radiologic diagnosis and therapy of the bile ducts. Results of endoscopic papillotomy].

Endoscopic-radiologic methods for demonstrating the hepatobiliary and pancreatic ducts are an integrated part of the diagnostic spectrum of gastroenterologic centers. At the Charité since 1975 we have made more than 5,500 endoscopic-retrograde cholangio-pancreaticographies (ERCP's). This method provides immediately or later an adequate therapy as an alternative to the otherwise necessary surgery.

[The significance of pulmonary artery angiography in the early postoperative phase following unilateral homologous lung transplantation].

In animal experiments there was carried out the homologous left-sided lung transplantation in quest of possibilities in therapy of the respiratory failure. Postoperative angiographies of the pulmonary artery took place in general anesthesia in 14 operated dogs to disclose vascular changes in the transplant at the early postoperative phase qualified by operation and rejection. The evaluation of the anastomosis of the pulmonary artery succeeded very well whereas the assertation about the venous anastomoses remains uncertain.