Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011206 (delirium)
5,996 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although the antimalarial agents chloroquine, hydroxychloroquine, and amodiaquine are widely used to treat a variety of medical conditions, their behavioral toxicity and lethality are not generally recognized. Therapeutic doses sometimes cause psychosis, delirium, personality change, and depression. Since moderately low overdoses of chloroquine can result in rapid death, such behavioral effects could lead to accidental or state-dependent overdosage and death.
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PMID:Behavioral toxicity and equivocal suicide associated with chloroquine and its derivatives. 32 63

Delayed neurological deterioration following anoxia is known to result from carbon monoxide exposure. However, it may also occur with anoxia of other types as well. The present report describes a case of delayed postanoxic encephalopathy with bilateral striatal lesions demonstrated by magnetic resonance imaging. A 27-year-old man exhibited anoxic anoxia caused by upper airway obstruction following general anesthesia for shoulder fracture surgery. Initially he was delirious and markedly excited for one day and became apparently normal for the following three days. Then he relapsed into delayed neurological deterioration with speech and gait disturbance, clumsiness of hand, pyramidal signs and metamorphopsia. Thereafter, he became bed-ridden and fell into semicomatose state with marked motor restlessness, involuntary movement of the tongue and decorticate posture. Twenty-five days later he had a second recovery period after hyperbaric oxygenation that lead to the sequelae with speech and motor disturbances and mild mental changes. I examined the present case as an expert witness in a civil suit eleven years after initial anoxia. The patient showed slight intellectual impairment and personality change. Impairment in figure-ground differentiation and disorders of spatial thought were also observed. Neurological examination revealed anisocoria, dysarthria with acquired stuttering, disturbances of fractionated movement of fingers, writer's cramp and Babinski's sign bilaterally. Postural dystonia of both hands and fingers, rigidity and spasticity of all extremities were also present. Magnetic resonance imaging (MRI) showed bilateral lesions of the corpus striatum, especially of the putamen. Some portion of the caudate nucleus was also involved. Cerebral cortices and white matter were slightly atrophic. From the above clinical course and neurological findings, we diagnosed the present case as delayed postanoxic encephalopathy. Ginsberg (1979) noted that in cases of anoxia not related to carbon monoxide, diffuse demyelinative changes of cerebral hemispheral white matter tended to be associated with relapsing clinical course, and gray matter injury was only seen in a few cases. MRI findings in the present case suggest that main site of the lesion to be in gray matter of the corpus striatum. In this respect, the present case is considered to be noteworthy.
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PMID:[A case of delayed postanoxic encephalopathy with bilateral lesions of the corpus striatum]. 281 6

A case is reported in which a lady suffered long-term personality change, a paranoid psychosis of several months duration, and an acute delirium, secondary to abuse of Vicks Sinex Nasal Spray and Vicks Vaporub. The problems were reversible on withdrawal of these well used products which have not previously been reported to cause psychological disturbance.
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PMID:Severe psychological disturbance resulting from abuse of nasal decongestants. 617 54

Manic-depressive states caused by drugs and various diseases consist of symptomatic psychosis, organic psychosis and toxic psychosis. Disturbance of consciousness is common to symptomatic psychosis. Emotional disturbance is associated with it. Dementia, personality change and disturbance of consciousness are common to organic psychosis. Emotional disturbance is also associated with these. Drug-induced manic-depressive states are classified by some studies. Drug-induced manic-depressive states are often caused by drugs for physical diseases. They are not originally psychotropic drugs. And they have affinity to the central nerve system, to some degree. Interferons cause disturbance of consciousness or delirious state in the acute phase and depressive state or numerous psychiatric symptoms in the chronic phase.
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PMID:[Manic-depressive states induced by drugs and various diseases]. 800 5

Interferon-alpha (IFN-alpha) is of high interest in the adjuvant treatment of malignant melanoma. During long term treatment, psychiatric side effects play an important role and not infrequently lead to reduction or discontinuation of therapy. Most common are sleeping disturbance, agitation, weariness, sleepiness, irritability, social withdrawal and depression, which most often develop during the first three months of the therapy. Also more severe side effects may occur, like delirium, organic depression, psychotic episodes and organic personality change, which in some patients may even lead to suicidal thoughts or suicide attempts, which is illustrated in two case reports. Therapeutic intervention depend to the severity of side effects. Moderate depressive syndromes may successfully be treated by antidepressive drugs like serotonin reuptake inhibitors (SSRI), which may even allow continuation of IFN-alpha therapy. In patients with severe depression or organic personality changes with increased risk of suicide, immideate discontinuation of IFN-alpha therapy is mandatory and treatment in a psychiatric hospital must be considered.
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PMID:[Psychiatric side effects during adjuvant therapy with interferon-alphain patients with malignant melanoma. Clinical evaluation as well as diagnostic and therapeutic possibilities]. 1050 82

This is a review on current knowledge of chronic occupational mercurialism syndrome. Major scientific studies and reviews on clinical manifestation and physiopathology of mercury poisoning were evaluated. The search was complemented using Medline and Lilacs data. Erethism or neuropsychological syndrome, characterized by irritability, personality change, loss of self-confidence, depression, delirium, insomnia, apathy, loss of memory, headaches, general pain, and tremors, is seen after exposure to metallic mercury. Hypertension, renal disturbances, allergies and immunological conditions are also common. Mercury is found in many different work processes: industries, gold mining, and dentistry. As prevention measures are not often adopted there is an increasing risk of mercury poisoning. The disease has been under diagnosed even though 16 clinical forms of mercury poisoning are described by Brazilian regulations. Clinical diagnosis is important, especially because abnormalities in the central nervous, renal and immunological systems can be detected using current medical technology, helping to develop the knowledge and control measures for mercurialism.
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PMID:[Chronic occupational metallic mercurialism]. 1248 28

Primary tumors and metastatic involvement of the central nervous system (CNS) lead to a multitude of symptoms and care needs. Patients and caregivers struggle with physical and psychological impairments, a shortened life expectancy and diverse palliative care needs. This study assesses the symptom burden and palliative care needs of patients with primary brain tumors and with metastatic brain tumors requiring inpatient hospital care. It is a retrospective analysis of patients with primary CNS tumors or cerebral metastases over a 6 month period. The data analysed included physical symptom burden and end of life care decisions such as health care proxy, transition to hospice and do-not-resuscitate orders. Hundred and sixty eight patients were included. The most common symptoms were gait impairment (65.5 %), cognitive/personality change (61.9 %), motor deficits (58.3 %), seizures (57.1 %) and delirium (27.4 %). Of the patients that died, 79 % had an appointed health care proxy, 79 % had hospice discussions, 70 % had a do-not-resuscitate order and 24 % received cancer directed therapy in the last month of life. There is a role for more aggressive palliative care support in patients living with primary or metastatic brain tumors.
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PMID:Identifying the palliative care needs of patients living with cerebral tumors and metastases: a retrospective analysis. 2246 38

Magnesium is one of the most important elements in the human body and is involved in a number of biochemical processes crucial for the proper functioning of the cardiovascular, alimentary, endocrine, and osteoarticular systems. It also plays a vital modulatory role in brain biochemistry, influencing several neurotransmission pathways associated with the development of depression. Personality changes, including apathy, depression, agitation, confusion, anxiety, and delirium are observed when there is a deficiency of this element. Rodents receiving a diet deficient in magnesium displayed depressive behaviour that was reversed by antidepressant drugs. Poor nutrition, gastrointestinal and renal diseases, insulin resistance and/or type 2 diabetes, alcoholism, stress, and certain medications may lead to magnesium deficiency. Since the extracellular concentration of magnesium ions may not reflect their intracellular level, none of the current methods of evaluating magnesium status is regarded as satisfactory. The mood-improving potential of magnesium compounds have been confirmed by the results of numerous pre-clinical and clinical studies. It seems that magnesium supplementation is well-tolerated and enhances the efficacy of conventional antidepressant treatments, and as such could be a valuable addition to the standard treatments for depression, although differences in bioavailability between inorganic and organic compounds should be taken into consideration.
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PMID:Magnesium and depression. 2791 Aug 8