2,789 results match your criteria: "Delirium Tremens"
Causal relationship between mitochondrial function and delirium: a bidirectional two-sample Mendelian randomisation analysis.
Psychogeriatrics
January 2025
Department of Anaesthesiology, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Precision Anaesthesia and Perioperative Organ Protection, Guangzhou, China.
Background: Previous studies have suggested a potential link between delirium and mitochondrial function. Consequently, this Mendelian randomisation (MR) study aimed to further investigate their causal relationship.
Methods: In this bidirectional MR study, the relationship between 73 proteins related to mitochondrial function and delirium, including delirium not induced by alcohol or other psychoactive substances (DEL) and delirium associated with alcohol withdrawal (AL-DEL).
Antibiotic prophylaxis reduced broad-spectrum antibiotics and length of stay in ICU patients with alcohol withdrawal induced refractory delirium tremens.
J Intensive Care Soc
November 2024
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Article Synopsis
Video Record Viewing of Self in Delirium Tremens (VVSDT) and its Effect on Abstinence among Patients with Alcohol Dependence Syndrome.
Indian J Psychol Med
August 2024
Spandana Nursing Home (Postgraduate Institute, DNB Psychiatry), Bengaluru, Karnataka, India.
Plasma neurofilament light chain levels are associated with delirium tremens in patients with alcohol use disorder.
Prog Neuropsychopharmacol Biol Psychiatry
November 2024
Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan; Psychiatric Research Center, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address:
Article Synopsis
Article Synopsis
- Buprenorphine is typically given sublingually for opioid withdrawal, but when that's not possible, intravenous (IV) or intramuscular (IM) methods can be effective alternatives despite limited practitioner experience in this area.
- A case series reviewed patient charts from an urban hospital who received parenteral buprenorphine between January 2020 and December 2021, focusing on demographics, medical and substance use histories, and withdrawal outcomes.
- Out of eight patients studied, the majority responded positively to the treatment, showing improvement in withdrawal symptoms, especially in cases with issues like delirium; no adverse effects were reported, indicating promise for this method in future applications.
Article Synopsis
- - Alcohol use disorder is prevalent in the U.S., and while benzodiazepines are typically recommended for alcohol withdrawal syndrome (AWS), there’s a growing trend to use phenobarbital, especially for patients at high risk of severe AWS.
- - A quality improvement study at a medical institution evaluated the effectiveness of a phenobarbital-based treatment protocol for AWS, measuring rates of protocol adherence and clinical outcomes before and after implementation.
- - Results showed a significant increase in the administration of phenobarbital, a decrease in the combined use of benzodiazepines, and a reduction in total benzodiazepine dosage, with improved safety outcomes such as fewer days in the ICU for those transferred.
Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in the Medical Intensive Care Unit (ICU): A Retrospective Cohort Study.
J Pharm Pract
September 2024
Department of Pharmacy, Michigan Medicine, Department of Clinical Pharmacy, College of Pharmacy, Ann Arbor, MI, USA.
Article Synopsis
- Phenobarbital (PHB) is found to be a safe and effective alternative to benzodiazepines (BZD) for treating severe alcohol withdrawal syndrome (AWS), but its safety in patients previously treated with BZD is unclear.
- A study compared critically ill patients with severe AWS receiving either PHB or BZD in the ICU to assess outcomes such as resolution of altered mentation, seizures, and length of hospital stay.
- Results showed no significant difference in the primary outcome between the two groups, but fewer seizures occurred in the PHB group, indicating that PHB may be a viable treatment option after BZD if patients are still experiencing uncontrolled withdrawal.
Article Synopsis
- The study focuses on the challenges of providing anesthesia care for patients with polytrauma and alcohol intoxication, particularly those experiencing alcoholic delirium, emphasizing the need for careful selection of sedation methods.
- The objective is to improve treatment outcomes by analyzing the effects of sedation on carbohydrate metabolism in these patients.
- Research involved 80 patients at a medical facility, where key indicators of carbohydrate metabolism were measured over a week to assess how sedation affects their recovery.
Agrypnia excitata: a human model to explore the derailment of sleep-wake cycle integrated control.
J Sleep Res
September 2024
Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy.
Article Synopsis
- * Agrypnia excitata leads to a loss of slow-wave sleep, continuous motor and autonomic overactivity over 24 hours, and unusual episodes of dream-like stupor.
- * This condition can occur in various situations like delirium tremens and fatal familial insomnia, prompting insights into how the brain manages sleep, wakefulness, and overall bodily balance.
Safety of Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in Critically Ill Patients With Primary Neurologic Injuries.
Ann Pharmacother
August 2024
Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Article Synopsis
- Alcohol withdrawal syndrome (AWS) is treated primarily with benzodiazepines, but recent studies suggest phenobarbital might be a safer and more effective treatment, especially in patients with neurological injuries.
- A study analyzed 84 ICU patients with neurological injuries who received either phenobarbital or benzodiazepines for AWS, measuring oversedation and other outcomes within 24 hours of treatment.
- Results showed no significant difference in oversedation or other secondary outcomes between the two treatments, although phenobarbital led to higher additional sedative use; overall, phenobarbital did not independently increase oversedation risk.
Gabapentinoids-Related Delirium Adverse Events: A Real-World Study from 2004 to 2022 Based on FAERS.
J Pain Res
August 2024
Department of Nephrology, Affiliated Hospital of Shanxi University of Chinese Medicine, Taiyuan, 030024, People's Republic of China.
Article Synopsis
- The study investigates the relationship between gabapentinoids (a class of medications) and various types of delirium using data from the FDA's Adverse Event Reporting System between 2004 and 2022.
- It analyzes a total of 2,950 reports, employing four different models to assess factors like age and sex, with initial findings indicating higher delirium rates in gabapentinoid users compared to non-users.
- Ultimately, the study suggests that while gabapentinoids are associated with increased delirium in most cases, this correlation diminishes when controlling for other confounding factors, particularly in Model 4.
Impact of a Delirium Protocol on Deliriogenic Medication Use in Hospitalized Older Veterans.
Sr Care Pharm
August 2024
Southern Arizona VA Health Care System, Pharmacy Service, Tucson, Arizona.
Article Synopsis
- The Southern Arizona VA Health Care System introduced a delirium prevention and treatment protocol in 2019 to assess its impact on medication use among hospitalized elderly veterans.
- A study analyzed data from 5,491 veterans aged 65 and older, comparing their experiences before and after the protocol's implementation across several metrics, including medication use and delirium diagnosis rates.
- Results showed no significant differences in deliriogenic medication usage, delirium diagnosis rates, or hospital length-of-stay before and after the protocol, suggesting its limited effectiveness on these outcomes.
A case of severe and prolonged γ-hydroxybutyrate (GHB) withdrawal syndrome successfully managed with a slow benzodiazepine and baclofen taper.
Drug Alcohol Rev
July 2024
Department of Addiction Medicine, St Vincent's Hospital, Melbourne, Australia.
Article Synopsis
- GHB (γ-hydroxybutyrate) is a powerful substance that affects the brain, similar to alcohol and ecstasy, and can lead to severe withdrawal symptoms that last longer than usually expected.
- A male patient in his 30s, with a long history of GHB use, experienced multiple severe withdrawal episodes over 56 days, requiring extensive medical intervention, including sedation and tracheal intubation.
- The case indicates that managing GHB withdrawal may need a slow tapering process to prevent recurring severe symptoms, suggesting that benzodiazepines and GABA-B receptor agonists are effective treatments.
Use of light activated intramedullary device for revision of a proximal humerus fracture: a case study.
Eur J Orthop Surg Traumatol
August 2024
Department of Orthopaedic Surgery, The University of Louisville School of Medicine, 323 East Chestnut Street, Louisville, KY, 40202, USA.
Article Synopsis
- A 45-year-old woman with a history of alcoholism experienced a proximal humerus fracture and initially underwent surgery using a lateral locking plate but faced complications due to falls caused by delirium tremens.
- After her condition worsened, she required revision surgery where the previous hardware was removed and a new fixation was done with the addition of a UV-activated intramedullary cement implant.
- This case is notable as it is the first reported use of UV-activated cement to strengthen the fixation for such fractures, addressing issues of non-compliance that could lead to surgical failure.
Alterations in Neurotrophins in Alcohol-Addicted Patients during Alcohol Withdrawal.
Brain Sci
June 2024
Department of Psychiatric Genetics, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
Article Synopsis
- - Alcohol use disorder (AUD) can lead to serious conditions like alcohol withdrawal syndrome (AWS) and delirium tremens (DTs), with neurotrophins potentially playing a significant role in their development and effects on the brain.
- - This review examined various neurotrophins and the protein S100B to understand their influence on neuroplasticity and neurodegeneration in relation to AUD, AWS, and DTs, using systematic research methods.
- - Key findings indicate that neurotrophins like BDNF and GDNF could serve as important biomarkers for monitoring relapse and withdrawal symptoms in AUD patients, although more research is needed to fully understand their roles in AWS and DTs.
Oral ethanol prescribing for alcohol withdrawal syndrome: initial findings and future directions following implementation within a United Kingdom National Health Service setting.
Clin Toxicol (Phila)
July 2024
Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
Article Synopsis
- A study was conducted to evaluate the use of oral ethanol as an alternative to benzodiazepines for managing alcohol withdrawal syndrome in patients within a UK health service setting.
- The research included a retrospective review of patients treated with either ethanol or benzodiazepines, focusing on those at high risk for severe withdrawal symptoms such as delirium tremens.
- Results indicated that patients managed with ethanol had a significantly lower likelihood of hospital admission, suggesting that oral ethanol could be a viable treatment option during alcohol withdrawal management.
Impact of an alcohol withdrawal screening and treatment protocol for hospitalized patients.
J Subst Use Addict Treat
September 2024
Cooper Medical School of Rowan University, United States of America; Cooper University Healthcare Center for Healing, United States of America. Electronic address:
Article Synopsis
- Alcohol Withdrawal Syndrome (AWS) poses serious risks for individuals with alcohol use disorder, making early detection essential in hospital settings, which led to the implementation of universal AUD screening using the PAWSS scale.
- A 6-year retrospective study compared patient outcomes before and after the introduction of a treatment protocol for AWS and involved 181 patients pre-protocol and 265 post-protocol.
- While the protocol did not significantly reduce hospital length of stay, it did lead to a notable decrease in the total benzodiazepine dose given and lower rates of delirium tremens among patients.
Article Synopsis
- A male patient in his seventies developed acute confusion, visual hallucinations, and cognitive issues due to leptomeningeal metastasis from gastric cancer, initially misdiagnosed as psychiatric disorders.
- The diagnosis was complicated by the lack of significant neurological findings and required repeat MRI and cerebrospinal fluid analysis for confirmation.
- This case emphasizes the need for thorough neurological assessments in patients presenting with psychiatric symptoms to avoid misdiagnosis of rare conditions like leptomeningeal metastasis.
Replacing the Clinical Institute Withdrawal Assessment-Alcohol revised with the modified Richmond Agitation and Sedation Scale for alcohol withdrawal to support management of alcohol withdrawal symptoms: potential impact on length of stay and complications.
CJEM
June 2024
Richmond Hospital (Drug and Alcohol Resource Team), Richmond, BC, Canada.
Article Synopsis
- A study was conducted to evaluate whether replacing the CIWA-Ar scale with the mRASS-AW scale for managing alcohol withdrawal in a busy hospital setting would impact patient outcomes, particularly length of stay and complications.
- The research involved a retrospective analysis of hospital data from 2012 to 2020, comparing the mean quarterly length of stay and other health outcomes for patients assessed with each scale.
- Results showed that switching to mRASS-AW did not increase the length of stay or the rate of complications, and it actually led to fewer post-admission complications compared to CIWA-Ar, suggesting mRASS-AW may be a viable alternative for patient management in emergency situations.
Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens.
J Clin Med
May 2024
Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia.
Article Synopsis
- Delirium Tremens (DT) is a severe complication of alcohol withdrawal syndrome (AWS), linked to neurotransmitter issues, inflammation, and increased bodily permeability, but its biomarkers are not well understood.
- The study compared healthy individuals and two AWS patient groups (with and without DT) to analyze various biomarkers, finding significant changes in certain biochemical markers and elevated inflammatory indicators in DT patients.
- Results suggested a subgroup of AWS patients exhibited high inflammation, indicating the complexity of patient profiles in AWS and highlighting the need for further research into specific biomarkers related to DT.
Delirium Tremens: A Review of Clinical Studies.
Cureus
April 2024
Department of Pain Medicine, Paolo Procacci Foundation, Rome, ITA.
Article Synopsis
- * The condition involves neurochemical imbalances, particularly with neurotransmitters like gamma-aminobutyric acid and glutamate, which arise from chronic alcohol use and result in symptoms like hyperexcitability.
- * Treatment primarily includes the use of benzodiazepines for symptom relief and ensuring patient safety, alongside careful monitoring of vital signs and electrolyte levels due to associated autonomic dysregulation; more research is needed to better understand DT, especially when it coexists with other medical conditions.
Continuous alcohol withdrawal delirium and physical illness-associated delirium in a man brought to the emergency department after a disaster: A case report.
Neuropsychopharmacol Rep
September 2024
Department of Psychiatry, School of Medicine, Dokkyo Medical University, Mibu, Japan.
Article Synopsis
- Risk factors for alcohol withdrawal delirium include heavy drinking, previous episodes of delirium, and various health issues like infections and tachycardia.
- A 76-year-old man with a history of heavy drinking and diabetes faced serious health issues after a typhoon, leading to severe alcohol withdrawal symptoms and delirium.
- The case highlights the necessity of a team-based approach for treatment in emergency situations and stresses the importance of ongoing care for elderly individuals with alcohol dependence after disasters.
"Should We Phenobarb-it-All?" A Phenobarbital-Based Protocol for Non-Intensive Care Unit Trauma Patients at High Risk of or Experiencing Alcohol Withdrawal.
Am Surg
June 2024
Department of Pharmacy, Maine Medical Center, Portland, ME, USA.
Article Synopsis
- A study evaluated a phenobarbital-based protocol for treating alcohol withdrawal syndrome (AWS) in non-ICU trauma patients to improve safety and effectiveness compared to traditional benzodiazepines.
- Results showed that fewer patients developed AWS-related complications after the protocol was implemented (17% POST vs 33% PRE), and benzodiazepine use significantly decreased (42% POST vs 88% PRE).
- Overall, the protocol did not increase adverse events or hospital length of stay, indicating that it is a safer alternative for managing AWS in trauma patients.