Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Though patients usually die peacefully, problems may arise in the last period of a terminal illness. In the final days new symptoms may arise or there may be exacerbation or recurrence of symptoms previously well controlled. Two hundred consecutive hospice patients were studied. The incidence was noted of pain, dyspnea, moist breathing, nausea and vomiting, confusion, restlessness, jerking and twitching, difficulty in swallowing, incontinence and retention of urine, sweating, moaning and groaning, and loss of consciousness. Each symptom is considered and the results of the management employed are noted. Many of the features appearing in the last days of a terminal illness, especially cancer, can be attributed to organic brain disease consequent to metabolic disorder associated with multi-organ failure. An awareness of the nature of the problems that may arise in the last 48 hours of life makes it possible to keep the patient comfortable to the end.
 ...
PMID:The last 48 hours of life. 170 17

Alzheimer's disease is characterized by progressive cognitive decline. However, little is known about the "typical" rate of decline, the degree of individual heterogeneity evident in decline, or the types of factors that influence such decline. This study investigated these questions in a sample of 106 patients with Alzheimer's disease, assessed at 1-5 points in time, spanning up to three years. At each time point, the Mini-Mental State Exam, a measure of global cognitive function, was administered to all patients. Measures of behavioral disturbance (including the presence/absence of hallucinations, depression, incontinence, wandering, and agitation), health status (including presence/absence of neurological, cardiovascular, and other diseases), and descriptive information (such as gender, age at time of onset, and duration of deficits) were obtained at entry into the study. A two-stage random effects regression model was fit to the data and then used to assess the effect of these behavioral, health, and descriptive measures on the rate of decline. Results indicate that the rate of cognitive decline in Alzheimer's disease is quite variable. Patients with various health and behavioral problems declined at a rate between 1.4 and 5 times faster than patients without such problems. Alcohol abuse, additional neurological disease, and agitation were significantly related to rate of decline. Overall number of problems was not. The association of these problems with accelerated decline may have prognostic and treatment implications.
 ...
PMID:Cognitive deterioration in Alzheimer's disease: behavioral and health factors. 231 49

Behavioral problems are thought to be pervasive and devastating to patients with dementia of the Alzheimer's type and their families. Despite this, little empirical data are available concerning the nature of such impairments, their rate of occurrence or their relationship to the disease process. This study investigated 127 patients with a primary diagnosis of dementia of the Alzheimer's type. Two methods of behavioral assessment were employed: a standardized dementia rating scale and a checklist of behavioral problems. Results indicated a) the overall number of problems significantly increased with increased cognitive impairment, b) the types of problems reported varied with cognitive severity, and c) behavioral problems were not significantly associated with patient's age, gender, duration, or age at onset of dementia. These findings are discussed as they relate to the phenomenology of dementia of the Alzheimer's type and to suggestions for interventions at different stages of the disease process. Problems found associated with level of impairment such as wandering, agitation, incontinence, and poor personal hygiene are thought to be characteristic of the disease and therefore predictable. Problems found not associated with level of impairment such as hallucinations, irrational suspicions, falls, and restlessness are likely to be idiosyncratic. The former should probably be incorporated into education and intervention programs; the latter addressed as needed on an individual basis.
 ...
PMID:Behavioral disturbance in dementia of the Alzheimer's type. 333 25

This study examined a geriatric rehabilitation pilot project on an acute-care medical unit. Over a 6-week period, using a 35-item geriatric rating scale and a mental assessment tool, changes in behaviours of 23 patients admitted to the geriatric rehabilitation module were compared to changes in behaviours of 10 elderly patients on a regular medical unit. The patients' demographic characteristics, their nursing and medical diagnoses, and discharge patterns were reviewed. Significant changes in behaviours of patients on the rehabilitation model included: increased ability to care for themselves, to maintain balance, and to communicate with others; decreased restlessness at night; decreased confusion; decreased incidence of incontinence; and improved social skills. The paper describes the geriatric rehabilitation programme and discusses implications for nursing of elderly patients in acute-care hospitals.
 ...
PMID:Geriatric rehabilitation on an acute-care medical unit. 656 47

Based on the discussion of NMS, certain conclusions may be reached in regard to this patient. In the psychiatric setting, agitation and confusion alone are not suggestive of NMS. However in this patient, the symptoms of agitation, the rapid development of EPS symptoms unresponsive to anticholinergic therapy, autonomic changes (tachycardia, diaphoresis, and incontinence), and elevated CPK, met most of the diagnostic criteria described in Table VI. However, this case may have described an atypical presentation of NMS because of the absence of temperature increases during the onset of symptoms and the 7-week hospitalization for NMS. The patient's later onset of temperature elevations was a result of an aspiration pneumonia. Pneumonia and renal failure significantly increased the morbidity and extended the course of the illness. As a result, the diagnosis and specific treatment of NMS were delayed because of atypical symptoms and complications. In this patient, treatment of NMS with bromocriptine did not start until 10 days into hospitalization. A delay in pharmacologic therapy in this patient may have contributed to persistence of symptoms. The patient showed signs of improvement on day 21 during combination bromocriptine, benztropine, and dantrolene therapy. Moreover, this case exemplifies the rigorous need for supportive therapy and adjunctive pharmacologic therapy for primary and secondary complications resulting from NMS. In conclusion, because of the wide range of risk factors and variations of NMS, a systematic approach to diagnosing and treating NMS is critical to a successful outcome. Discontinuation of antipsychotics, maintenance of supportive therapy aimed at preventing dehydration, hemodynamic, and electrolyte imbalances, and pharmacotherapy are essential in the treatment of NMS.
 ...
PMID:An atypical course of neuroleptic malignant syndrome. 800

Since the late 1970s, ecstasy (MDMA) has enjoyed increasing popularity as a recreational drug. We report a dramatic increase in reports of ecstasy ingestion to the National Poisons Information Centre from zero in January 1991 to thirty seven in June 1992. We have analysed these thirty seven cases retrospectively for age and sex distribution, clinical details and outcome. The patients involved were predominantly male (80%) and aged 10-30 years, the highest incidence being in the 16-25 year old age group. Thirty two (86%) patients were symptomatic. Symptoms in most cases were relatively mild. One death was reported due to congestive heart failure. The symptoms most frequently reported include dilated pupils, agitation, excitement, hallucinations, tachycardia, palpitations, CNS depression, incontinence and psychiatric symptoms.
 ...
PMID:Ecstasy abuse in Ireland. 810 42

Involvement of the central nervous system associated with SLE (CNS lupus) is not rare. Two types of CNS lupus are noted clinically; one group manifesting focal neurological symptoms and another group showing mental symptoms. Though it is well known that neurological symptoms are caused by arteritis and thrombus, pathophysiological mechanisms leading to mental symptoms remain obscure and there is no established clinical evidence responsible for these symptoms. A 41-year-old woman was confused and her attention was markedly impaired. Her mental symptoms consisted of disorientation, restlessness, euphoria and emotional incontinence. There were neither focal neurological signs nor meningeal signs. Cerebrospinal fluid (CSF) examination showed increased number of polymorphonuclear cells and permeability of the blood-brain barrier, calculated based on the CSF/plasma protein ratio, was also elevated. Repeated bacteriological examinations revealed to be negative. Gd-DTPA MRI demonstrated diffuse enhancement of the cerebral leptomeninges. Methylprednisolone pulse therapy ameliorated her mental deterioration effectively, and subsequently the leptomeningeal enhancement with Gd-DTPA MRI disappeared in parallel. These radiological and laboratory findings suggest that SLE itself causes inflammation of vessels in the leptomeninges and adjacent cerebral cortex. We consider mental symptoms associated with SLE may be caused, at least in part, by this mechanism. To our knowledge, we could not find similar reports in the literature. Gd-DTPA enhanced MRI seems to be of clinical use for making diagnosis, evaluating clinical activity and understanding of CNS lupus.
 ...
PMID:[Leptomeningeal abnormality on Gd-DTPA enhanced MRI in a case of SLE presenting diffuse organic brain syndrome]. 833 80

Three patients, two men of 21 and 38 years and a woman of 20 years old, showed atypical seizures with motor agitation without tongue bite, incontinence or postictal confusion. After extensive video-EEG registration frontal lobe epilepsia was diagnosed. This is a relatively recently recognized disease entity.
 ...
PMID:[Paroxysmal and bizarre motor agitation as manifestation of partial frontal lobe epileptic seizures]. 866 79

Although memory disorders and the aphaso-apraxo-agnosic syndrome are the most relevant clinical symptoms in dementia, behavioral changes, mood-related disturbances and sleep disorders are the major cause of institutionalization and caregiver concern. In the present study we have investigated the frequency and progression of cognitive and noncognitive symptoms in Alzheimer's disease (AD) as well as the APOE-related frequency of clinical symptoms in dementia. Memory decline (100%), aphasia (94%), apraxia (99%), agnosia (94%) and motor dysfunction (90%) appeared in practically all cases with mild (GDS-3), moderate (GDS 3-4) and severe (GDS 6-7) dementia. The most frequent noncognitive symptoms include anxiety (76%), depression (68%), behavioral changes (67%), psychotic symptoms (43%), sleep disorders (43%), incontinence (23%) and cerebrovascular symptoms (75%). Anxiety, depression, behavioral changes, psychotic symptoms, motor dysfunction and cognitive deterioration paralleled the severity of dementia, increasing their frequency from mild to severe dementia. The most important sleep disorders were irregular sleep-wake pattern (67%) and insomnia (47%). Disorientation (90%) and drug administration (88%) appeared to be the most important factors in causing sleep disorders in dementia. Disorientation, agitation and motor disorders were slightly more frequent in patients with APOE-4/4, while anxiety and sleep disorders appeared more frequently in APOE-3/4. Behavioral changes and psychotic symptoms did not show any clear association with specific APOE subtypes. In conclusion, our results suggest that noncognitive symptoms are very important clinical events in the disease progression and in decision making for therapeutic intervention and institutionalization. Furthermore, it is likely that some brain dysfunctions leading to particular clinical symptoms might be associated with specific AD genotypes.
 ...
PMID:APOE-related frequency of cognitive and noncognitive symptoms in dementia. 912 Dec 26

In a study of 50 family caregivers of elderly Chinese patients with dementia in Singapore, 28 (56%) scored five points or more on the 28-item General Health Questionnaire (GHQ). The GHQ scores correlated significantly with duration of care; presence of delusion, hallucination, depression, insomnia, incontinence and agitation; and the total score of the Behavioural Pathology in Alzheimer's Disease Rating Scale. On multiple regression analysis the only variables to achieve a significant relationship with the GHQ scores were duration of care, depression and the total behavioural score.
 ...
PMID:Stress of caregivers of dementia patients in the Singapore Chinese family. 917 51


1 2 3 4 Next >>