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Journal articles on the topic 'Altered mental status (AMS)'

Author: Grafiati

Published: 5 June 2025

Last updated: 2 August 2025

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1

Gajender, Kumar Kumawat, Pipliwal P.S., Kumar Kasana Rajendra, and Ishran Rohit. "Altered Mental Status Patients Associated Evaluations in the Medicine Department." International Journal of Pharmaceutical and Clinical Research 15, no. 1 (2023): 1082–89. https://doi.org/10.5281/zenodo.13155044.

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<strong>Background: </strong>Altered mental status (AMS) comprises a group of clinical symptoms rather than a specific diagnosis, and includes cognitive disorders, attention disorders, arousal disorders and decreased level of consciousness. Patients often manifest vague symptoms, thus, AMS diagnosis and treatment are highly challenging for general medicine physicians. <strong>Material & Methods: </strong>Within the Department of General Medicine, SMS Medical College and the attached group of hospitals, Jaipur, our research team explored patterns in 150 AMS patients from June

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Meet, Patel, Patel Prakruti, and Patel Rushi. "Clinical Study of Patients Presenting with Acute Altered Sensorium." International Journal of Pharmaceutical and Clinical Research 16, no. 7 (2024): 858–61. https://doi.org/10.5281/zenodo.13120080.

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Background: Altered sensorium poses a significant and challenging diagnostic task for emergency physicians in managing patients promptly. Non-traumatic causes of altered mental status are diverse and require compre-hensive clinical knowledge for effective management in the emergency room (ER), aiming to reduce morbidity and mortality. Therefore, understanding the clinical profile, triaging, treatment, and outcomes is crucial to op-timize ER resources, especially in settings with limited resources. Objective: This study aimed to investigate the clinical profile, emergency management, and outcom

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Khan, Jamal Azfar, Hassaan Mehmood, and Muhammad Irfan Khattak. "Altered Mental Status and Its Causes: Commonest Dilemma of Residents and Emergency Physicians." Pakistan Armed Forces Medical Journal 72, no. 5 (2022): 1770–73. http://dx.doi.org/10.51253/pafmj.v72i5.7337.

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Objective: To assess the frequency of the various medical conditions in patients presenting with altered mental status (AMS) in the Emergency Department of Pakistan Naval Ship (PNS) Shifa Hospital. Study Design: Prospective longitudinal study. Place and Duration of Study: Emergency Department, Pak Naval Ship Shifa Hospital, Karachi Pakistan from Feb-Jul 2021. Methodology: Adult patients who have presented with altered mental status (Glasgow coma scale score less than 15) or who have the diagnosis "AMS" written in their notes were included in the study. Patients were observed

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Millard, John W., Crystal K. Howell, and Brittany N. Palasik. "Asymptomatic But Altered? When Urinalysis Holds the Key." Senior Care Pharmacist 36, no. 8 (2021): 381–86. http://dx.doi.org/10.4140/tcp.n.2021.381.

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Altered mental status (AMS) is a common symptom in geriatric patients, especially in the long-term care setting. Traditionally, AMS has been associated with urinary tract infections (UTIs) in older people. However, data correlating UTIs with AMS are lacking. For this reason, asymptomatic bacteriuria (ASB) guidelines do not recommend using non-specific symptoms, such as AMS, to indicate a potential diagnosis of UTI. It is important to distinguish between colonization and infection, which can be done through proper interpretation of a urine analysis in the presence of UTI-specific symptomatology

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Muñoz, Monica A., Nakyung Jeon, Benjamin Staley, et al. "Predicting medication-associated altered mental status in hospitalized patients: Development and validation of a risk model." American Journal of Health-System Pharmacy 76, no. 13 (2019): 953–63. http://dx.doi.org/10.1093/ajhp/zxz119.

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Abstract Purpose This study presents a medication-associated altered mental status (AMS) risk model for real-time implementation in inpatient electronic health record (EHR) systems. Methods We utilized a retrospective cohort of patients admitted to 2 large hospitals between January 2012 and October 2013. The study population included admitted patients aged ≥18 years with exposure to an AMS risk–inducing medication within the first 5 hospitalization days. AMS events were identified by a measurable mental status change documented in the EHR in conjunction with the administration of an atypical a

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Hilal Ahmad, Sheikh, Wani A. Mushtaq, and Tak Sajad. "Prognostic factors of outcome in adults with non-traumatic altered mental status presenting to emergency department." International Journal Of Community Medicine And Public Health 6, no. 5 (2019): 1948. http://dx.doi.org/10.18203/2394-6040.ijcmph20191554.

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Background: Altered mental status (AMS) is a common presentation in the emergency department (ED) and poses a significant challenge to the emergency physician (EP). The prognosis seems to depend upon many diverse factors, like etiology of AMS patient, clinical variables and various laboratory tests.Methods: The aim of the study was to determine outcome in patients presenting with new onset AMS to emergency department in our population. And further to look for various prognostic factors for death. Adult patients aged >14 years, not having dementia and with no history of trauma, presenting to

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Polyak, Alexander, Serguei Bannykh, Andrew Klein, and Vinay Sundaram. "Neurologic Imaging in a Patient with Cirrhosis and Altered Mental Status: To CT or Not to CT." Case Reports in Gastrointestinal Medicine 2021 (July 30, 2021): 1–3. http://dx.doi.org/10.1155/2021/5588208.

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Hepatic encephalopathy represents a continuum of neuropsychiatric symptoms among patients with end-stage liver disease. When a patient with cirrhosis presents with altered mental status (AMS), routine neurologic imaging is not typically recommended, due to low diagnostic yield. Guidance from the American Association for the Study of Liver Disease states that, on initial presentation, brain imaging is not required unless there are other signs of intracranial pathology, including focal neurologic deficits. We present a case of a 61-year-old female with cirrhosis presenting with AMS without focal

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Acharya, Roshan, Smita Kafle, Dhan Bahadur Shrestha, et al. "Use of Computed Tomography of the Head in Patients With Acute Atraumatic Altered Mental Status." JAMA Network Open 5, no. 11 (2022): e2242805. http://dx.doi.org/10.1001/jamanetworkopen.2022.42805.

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ImportanceThe usefulness of computed tomography of the head (CTH) in patients with acute-onset atraumatic altered mental status (AMS) is poorly understood, but use in these patients remains high.ObjectiveTo evaluate the use of CTH (event rate) in patients with AMS and the positive outcome event rate of the performed CTH studies.Data SourcesThe PubMed/MEDLINE, PubMed Central, Embase, and CINAHL databases were searched using predefined Boolean parameters. All studies that met inclusion criteria until January 31, 2022, were included.Study SelectionRandomized clinical trials and observational, coh

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Ohene-Adjei, Michael, Sabrina Leone Begley, Richard Temes, and Michael Schulder. "Efficacy of continuous electroencephalogram for the management of altered mental status in the neurosurgical intensive care unit." Surgical Neurology International 14 (July 7, 2023): 235. http://dx.doi.org/10.25259/sni_409_2023.

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Background: Continuous electroencephalograms (cEEGs) are often used in the neurosurgical intensive care unit (NSICU) to detect subclinical seizures (SCSs) in patients with altered mental status (AMS). This retrospective study evaluated the efficacy of this approach for improving patient outcomes. Methods: We reviewed the records of 100 patients admitted to the NSICU between 2015 and 2020 who underwent continous electroencephalograms (cEEG) during workup of unexplained AMS. Patient outcomes were classified as positive (discharged), neutral (transfer of care), or negative (dead). Incidence of SC

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Batool, Syeda Nida, Syeda Fatima Zareen, Syeda Kiran Batool, Fahim Liaqat, Zeeshan Munir, and Syed Waqar Abbas. "Prognostic Factor of Outcome in Adults with Altered Mental Status Presenting in Emergency Department." Pakistan Armed Forces Medical Journal 73, no. 4 (2023): 1208–11. http://dx.doi.org/10.51253/pafmj.v73i4.7338.

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Objective: To determine the prognostic factors which affect the outcome and mortality in patients of Altered Mental Status at the emergency department. Study Design: Cross sectional study. Place and Duration of Study: Emergency Department of Combined Military Hospital, Rawalpindi Pakistan, from Dec 2020 to June 2021. Methodology: A total 90 patients were selected with the age range of 18-75 years who met the inclusion and exclusion criteria. Patients with prior history of trauma, dementia or any other mental illness were excluded. Patient’s complete history and examination was performed by eme

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Ahmed, Mohd Muqtader, P. Ravi, K. E. Pravallika та Sarwat Hazeeqa. "Studies on Risperidone Loaded β-Cyclodextrin Nanosponges for Managing Altered Mental Status and Delirium in Cancer Patients". Journal of Cancer Research Updates 13 (25 грудня 2024): 66–74. https://doi.org/10.30683/1929-2279.2024.13.09.

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This study explores the prospective of risperidone-loaded β-cyclodextrin nanosponges as a therapeutic strategy for managing altered mental status (AMS) and delirium in cancer patients. Almost 87% of patients with advanced cancer experience AMS or delirium, significantly impacting prognosis and quality of life. The present study aims to enhance the solubility, bioavailability, and therapeutic effectiveness of second-generation antipsychotic medication risperidone (RSP), with poor aqueous solubility, it was encapsulated in β-cyclodextrin nanosponges. The nanosponges prepared by fusion technique

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Wizowska, Joanna, Damian Hyla, Rafał Jakobson, and Dorota Zyśko. "Altered mental status is an independent from age, gender, and low oxygen saturation risk factor for long term mortality in patients with COVID-19." Emergency Medical Service 10, no. 3 (2023): 163–66. http://dx.doi.org/10.36740/emems202303104.

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Aim: The aim of the study was to determine the clinical characteristics and long term survival in patients with SARS-CoV-2 infection presenting with AMS. Material and methods: Retrospective analysis of the medical records was performed. The patients were divided into a group 1 with AMS and a group 2 without AMS. Demographics, the presence of concomitant diseases, systolic and diastolic blood pressure, heart rate and peripheral oxygen saturation (SpO2) were compared between the group that presented with AMS and the group that did not present with AMS. Survival analysis was performed with multip

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Kushwah, Saraswati, Pritam Singh, Kamal Singh, Daljinderjit Kaur, and Sarabmeet Singh Lehl. "Aetiologic Profile of Patients with Altered Mental Status in Medical Emergency in a Tertiary Care Medical Institute - A Cross Sectional Observational Study." Journal of Evidence Based Medicine and Healthcare 8, no. 9 (2021): 456–61. http://dx.doi.org/10.18410/jebmh/2021/89.

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BACKGROUND Altered mental status (AMS) is a symptom complex that may arise from a variety of primary neurologic disorders and systemic illnesses. The underlying diagnosis affects final outcome of patients that may be predicted by use of objective tools. This study was conducted to describe the aetiologic distribution of such patients presenting to emergency room and assess the utility of Richmond Agitation Sedation Scale (RASS) and Glasgow Coma Scale (GCS) as prognostic tools. METHODS In this cross-sectional observational study, we identified such 120 adult patients at a single centre tertiary

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Davis, Elizabeth, and Rima Chakraborty. "Non-convulsive status epilepticus: an often-overlooked etiology of syndrome of inappropriate antidiuretic hormone secretion." International Journal of Research in Medical Sciences 5, no. 5 (2017): 2251. http://dx.doi.org/10.18203/2320-6012.ijrms20171881.

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Altered mental status is a common presenting complaint in adult medicine with a broad differential diagnosis. When found in the context of chronic medical conditions, less common etiologies can be overlooked. We present a case of acute altered mental status thought to be secondary to acute on chronic hyponatremia in the context of syndrome of inappropriate antidiuretic hormone secretion (SIADH), eventually diagnosed as non-convulsive status epilepticus, partial type. We report the case of a 67-year-old patient with known SIADH of unknown etiology, hypertension, chronic pancreatitis and chronic

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Charles, Creaque V., Keilon Robinson, and Sharmaine Santillan. "New Onset Diabetes in an Older Patient: An Unforeseen Phenomenon." Senior Care Pharmacist 37, no. 10 (2022): 495–98. http://dx.doi.org/10.4140/tcp.n.2022.495.

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In this case, an 86-year-old man with a history of recurrent urinary tract infections (UTIs) is brought to the emergency room with altered mental status (AMS) and frequent falls. According to the patient's son, the patient had a significant decline and became more dependent in both his regular and instrumental activities of daily living. Upon admission, the patient was found to be in a hyperosmolar hyperglycemic state and eventually diagnosed with diabetes. A review of the patient’s medications indicated that polypharmacy may be a contributing factor to his current mental status changes and fa

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Sacino, Mathew, Kathleen Sheridan Lubinsky, and Elizabeth Holton. "A Case of Altered Mental Status and Severe Frontal Headaches in Patient with Imaging Confirmed Pneumocephalus and a Review of Previous Cases." Journal of Clinical Case Studies Reviews & Reports 2, no. 6 (2020): 1–4. http://dx.doi.org/10.47363/jccsr/2020(2)157.

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Neuraxial anesthetic technique is a common and safe method of providing labor analgesia and anesthesia for cesarean section (CS). Pneumocephalus (PC) is a known rare complication from neuraxial anesthesia. Here we present a case of a high risk parturient for planned CS via spinal anesthesia with catheter technique who experienced altered mental status (AMS) and severe headaches due to PC confirmed by head computed tomography (CT). Additionally, we review and discuss the body of literature of pneumocephalus resulting from neuraxial technique.

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Kim, B., Q. Salehmohamed, R. Stenstrom, S. Barbic, and D. Barbic. "MP14: Prospective external validation of the Ottawa 3DY screening tool for the detection of altered mental status of elderly patients presenting to the emergency department." CJEM 19, S1 (2017): S69—S70. http://dx.doi.org/10.1017/cem.2017.180.

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Introduction: Altered mental status (AMS) and cognitive impairment are common problems in elderly patients presenting to the emergency department (ED). The primary objective of this study was to test the diagnostic accuracy of the Ottawa 3DY (O3DY) screening tool for the detection of AMS in the ED. Methods: This was a prospective cohort study conducted at an inner city, academic ED with an annual census of 85,000 visits. Study investigators and trained research assistants screened and approached a convenience sample of patients for informed written consent. Patients completed the O3DY, Short B

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Mysore, Channaiah Srikanth, Najib Murr, Rana Zabad, and John Bertoni. "Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern." Case Reports in Neurological Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/6987821.

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Objective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and another patient with secondary progressive multiple sclerosis (SPMS), both presenting with altered mental status (AMS) and later diagnosed with nonconvulsive atypical absence status epilepticus (AS), with atypical EEG changes. Methods. A report of two cases. Results. A patient with history of SREAT and the other with SPMS had multiple admissions due to AMS. For both, EEG revealed the presence of a high voltage generalized sharply contoured theta activity. A

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Harrington, Nicole, Jessica Leri, and Scott Shoop. "1111. Characterization of Antibiotic Ordering in Patients with Mental Status Changes and Presumed Urinary Tract Infection in Patients 65 and Older." Open Forum Infectious Diseases 6, Supplement_2 (2019): S395—S396. http://dx.doi.org/10.1093/ofid/ofz360.975.

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Abstract Background Altered mental status (AMS) is the most common diagnosis among those 65 and older who present to the emergency department (ED). Urinary tract infections (UTIs) account for 15.5% of hospitalizations in this population. The purpose of this study was to determine the incidence of initiation of antibiotics in the ED in patients 65 years and older with mental status changes and asymptomatic bacteriuria or negative urine cultures. Methods A retrospective chart review was performed to evaluate patients aged 65 and older from January 2017 through June 2018 who presented to the ED f

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Ghani, Sadia B., Eric Taylor, and Siddesh Gopalakrishnan. "Is this Withdrawal or Intoxication? Case Report Regarding Complications of Unregulated Use of Tianeptine, Etizolam, and Phenibut in the USA." CNS Spectrums 26, no. 2 (2021): 169. http://dx.doi.org/10.1017/s1092852920002734.

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AbstractBackgroundThe internet allows easy access for the sales of psychoactive agents that are not regulated by the FDA. Some of those agents are used to help manage anxiety, depression and sleep, such as tianeptine, etizolam, and phenibut. These medications have the potential for abuse and potentially leading to altered mental status when intoxicated or withdrawing. This presents a challenge to clinicians who may not be aware of availability of such substances. Available literature has discussed the use of above substances individually, but how do you treat if there is use of more than one s

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GUEVARA, NEHEMIAS, FLOR ROSADO, IURII STATNI, TABATA HERNANDEZ, and IVETTE VIGODA. "A CASE OF PERIPHERAL T-CELL LYMPHOMA (PTCL) WITH ALTERED MENTAL STATUS (AMS) AND LEUKEMOID REACTION (LR) IN THE COURSE OF THE DISEASE." CHEST 164, no. 4 (2023): A2247—A2248. http://dx.doi.org/10.1016/j.chest.2023.07.1516.

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Fazeel, Hussain. "Encephalitis and Acute Hemolysis Secondary to Paraneoplastic Syndrome From Renal Carcinoma: A Rare Presentation." International Clinical and Medical Case Reports Journal 3, no. 9 (2024): 1–6. https://doi.org/10.5281/zenodo.13827804.

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This case report details a 76-year-old man with stage 4 chronic kidney disease (CKD) who presented with altered mental status (AMS) and was subsequently diagnosed with encephalitis and hemolysis due to a paraneoplastic syndrome secondary to renal cell carcinoma (RCC). The patient's clinical course was complicated by acute chronic anemia, thrombocytopenia and left-sided kidney. Despite initial improvement after plasmapheresis and steroid treatment, the patient's condition worsened, prompting initiation of intravenous immunoglobulin (IVIG) for suspected paraneoplastic encephalitis. Multidiscipli

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Rice, Shannon D., Nina Kim, and Charlotte Farris. "Anticholinergic Cognitive Burden in Older People Over Acute Admission." Senior Care Pharmacist 36, no. 2 (2021): 104–11. http://dx.doi.org/10.4140/tcp.n.2021.104.

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Objective To evaluate the change of geriatric anticholinergic cognitive burden (ACB) over acute admission for fall, fracture, or altered mental status (AMS) with a secondary endpoint of associated 30-day all-cause readmission. Design Retrospective, single-center chart review. Setting An academic, 636-bed level-I trauma and tertiary care hospital in Texas. Patients, Participants Participants at least 65 years of age admitted for acute fall, fracture, or AMS between January 1, 2014, and August 31, 2018. A total of 265 participants were included; average age was 83 years, with 56% female. Main Ou

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Lipow, Matthew, Syed Kaleem, and Eduardo Espiridion. "NBOMe Toxicity and Fatalities: A Review of the Literature." Transformative Medicine 1, no. 1 (2022): 12–18. http://dx.doi.org/10.54299/tmed/msot8578.

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In the decade since the introduction of the novel synthetic hallucinogen NBOMe into the consumer market, this drug has become an increasingly prevalent, yet poorly understood cause of altered mental status (AMS) resulting in hospitalization. In this literature review, we conducted a PubMed query for mentions of NBOMe ingestion since Suzuki et al.’s publication of their 2015 review. Among English language publications published between October 2014 and June 8, 2021, were sixteen case reports and six case series detailing a total of 42 cases of NBOMe toxicity. Notably, 26 (62%) patients experien

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Rice, Shannon D., Nina Kim, and Charlotte Farris. "Anticholinergic Cognitive Burden in Older People Over Acute Admission." Senior Care Pharmacist 36, no. 2 (2021): 104–11. http://dx.doi.org/10.4140/tcp.n.2021.104.

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OBJECTIVE: To evaluate the change of geriatric anticholinergic cognitive burden (ACB) over acute admission for fall, fracture, or altered mental status (AMS) with a secondary endpoint of associated 30-day all-cause readmission.<br/> DESIGN: Retrospective, single-center chart review.<br/> SETTING: An academic, 636-bed level-I trauma and tertiary care hospital in Texas.<br/> PATIENTS, PARTICIPANTS: Participants at least 65 years of age admitted for acute fall, fracture, or AMS between January 1, 2014, and August 31, 2018. A total of 265 participants were included; average age w

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Datla, S., K. Parker, L. Robert, and N. Soloman. "P18: MULTIPLE DIAGNOSIS OR CONTINUUM OF DISEASE: MULTICENTRIC CASTLEMAN'S DISEASE." Journal of Investigative Medicine 64, no. 3 (2016): 824.1–824. http://dx.doi.org/10.1136/jim-2016-000080.58.

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Purpose of StudyMulticentric Castleman's disease (MCD) is a rare lymphoproliferative disorder characterized by peripheral lymphadenopathy (LAD), hepatosplenomegaly(HSM), and B symptoms. It is associated with HIV and HHV8 infection.We report a case of young woman presented with B symptoms, workup suggestive of lupus but lymph node biopsy (BX) was consistent with MCD. Association of SLE with MCD is rare. We report this case to increase awareness of this potential diagnostic and therapeutic dilemma.Methods UsedPatient is a 27 yr old black woman presented with malaise, fevers, cough, weight loss,

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Pate, Amy, Carlos Franco-Paredes, and Andres Henao-Martinez. "1717. Cryptococcal Meningitis: A Comparison of Clinical Features and Outcomes by HIV Status." Open Forum Infectious Diseases 6, Supplement_2 (2019): S629—S630. http://dx.doi.org/10.1093/ofid/ofz360.1580.

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Abstract Background Cryptococcal meningitis is an opportunistic fungal infection associated with HIV and other forms of immunosuppression. We lack a clear understanding of cryptococcal meningitis (CM) among HIV-negative patients in the United States. Our aim was to compare clinical features and outcomes across HIV status in patients with laboratory-confirmed cryptococcal meningitis. Methods We conducted a retrospective cohort study of patients with laboratory-confirmed (positive culture or antigen test) cryptococcal disease treated at a tertiary care center from January 2000 to September 2018.

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Ponciano, Ana, Vera Vieira, José Leite, and Célio Fernandes. "Posterior Reversible Encephalopathy Syndrome: A Case of Hypercalcemia." Acta Médica Portuguesa 31, no. 6 (2018): 338. http://dx.doi.org/10.20344/amp.9714.

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Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemi

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Motoa, Gabriel, Amy Pate, Daniel Chastain, et al. "Increased cryptococcal meningitis mortality among HIV negative, non-transplant patients: a single US center cohort study." Therapeutic Advances in Infectious Disease 7 (January 2020): 204993612094088. http://dx.doi.org/10.1177/2049936120940881.

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Cryptococcal meningitis (CM) is an opportunistic fungal infection associated with human immunodeficiency virus (HIV) and other forms of immunosuppression. We lack a clear understanding of CM associated mortality among HIV-negative, non-transplant patients in the United States (US). This article compares clinical features and outcomes across HIV status in patients with laboratory-confirmed CM. Methods: A retrospective cohort study was performed that included adult patients with laboratory-confirmed CM treated at an academic tertiary hospital between January 2000 and September 2018. Those with a

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Makkawi, Seraj, Shatha Alqurashi, Wejdan Hubayni, et al. "The Clinical Manifestations, Risk Factors, Etiologies, and Outcomes of Adult Patients with Infectious Meningitis and Encephalitis: Single Center Experience." Neurology International 16, no. 5 (2024): 966–75. http://dx.doi.org/10.3390/neurolint16050073.

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(1) Background: Central nervous system (CNS) infections, including meningitis and encephalitis, are serious conditions which are associated with high morbidity and mortality. This study aims to identify the clinical manifestations, etiologies, and outcomes of meningitis and encephalitis in adult patients in Saudi Arabia, addressing the current gap in understanding these conditions within this population. (2) Methods: This is a single-center retrospective study which included all adult patients diagnosed with meningitis and encephalitis from March 2016 to May 2022. (3) Results: This study found

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Shahbaz, Anees, Sinha Kanishk, Yadav Jyoti, et al. "Spectrum of Central Nervous System Tuberculosis: An Experience from a Major Tertiary Care Institution in India." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 2439–43. https://doi.org/10.5281/zenodo.13824008.

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<strong>Background:</strong> Central nervous system tuberculosis (CNS TB) is a critical form of extrapulmonary TB that poses significant diagnostic and therapeutic challenges, particularly in high-burden regions like India. Despite advances in TB control, CNS TB continues to contribute to substantial morbidity and mortality due to its complex presentation and severe outcomes. This study aims to explore the clinical, radiological, and laboratory spectrum of CNS TB and to identify key factors associated with poor outcomes. <strong>Methods:</strong> A retrospective observational st

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Alsulimani, Loui K., Ohoud Baajlan, Khalid Alghamdi, Raghad Alahmadi, Abdullah Bakhsh, and Jameel Abualenain. "Effects of Not Intubating Non-Trauma Patients With Low Glasgow Coma Scale Scores: a Retrospective Study." Journal of Medicine, Law & Public Health 2, no. 1 (2022): 83–90. http://dx.doi.org/10.52609/jmlph.v2i1.41.

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Background: Endotracheal intubation (EI) is a critical life-saving procedure commonly performed on emergency department (ED) patients who present with altered mental status (AMS). Aims: We aimed to investigate the safety of observing, without EI, patients who present to the ED with decreased levels of consciousness (LOC). Methods: We reviewed the data of all adult ED patients with a Glasgow Coma Scale (GCS) score ≤ 8, during the period between 2012 and 2018, in an academic tertiary care centre. Trauma patients were excluded. The patients were divided into two groups for comparison: those who w

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Chauhan, Nabeel, Syed F. Ali, Yousef Hannawi, and Archana Hinduja. "Utilization of Hospice Care in Patients With Acute Ischemic Stroke." American Journal of Hospice and Palliative Medicine® 36, no. 1 (2018): 28–32. http://dx.doi.org/10.1177/1049909118796796.

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Background: A significant percentage of terminally ill patients are discharged to hospice care following a devastating stroke. Objective: We sought to determine the factors associated with hospital discharge to hospice care in a large cohort of patients with stroke. Methods: Using the institutional Get With The Guidelines-Stroke database, all consecutive patients with acute ischemic stroke (AIS) who were alive at discharge, from January 2009 until July 2015, were analyzed. Univariate and multivariable statistical analyses were performed to determine the factors associated with discharge to hos

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Aljuboori, Zaid, Mohammed Nuru, Alexandria Schaber, Haring Nauta, and Emily Sieg. "Delayed recurrence of acute subdural hematoma in a patient with plasminogen activator inhibitor mutation." Surgical Neurology International 11 (September 18, 2020): 292. http://dx.doi.org/10.25259/sni_180_2020.

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Background: Plasminogen activator inhibitor type I (PAI-1) is important for balancing the fibrinolytic effect of plasmin, and deficiency can result in increased risk of bleeding. We report a case of a patient with PAI-1 deficiency who presented with delayed spontaneous recurrence of an acute subdural hematoma (aSDH) after evacuation. Case Description: A 29-year-old male presented with altered mental status (AMS) after a fall at a construction site with Glasgow Coma Scale (GCS 4T). His coagulation profile was normal, and brain computed tomography (CT) showed a left-sided aSDH. He underwent emer

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Carroll, Ryan David, E. Cindy Leigh, Zachary Curtis, Anthony Thorpe, Jason Ballengee, and Toni Pacioles. "A Case of Leptomeningeal Carcinomatosis from Aggressive Metastatic Prostate Cancer." Case Reports in Oncology 12, no. 1 (2019): 311–16. http://dx.doi.org/10.1159/000499761.

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Leptomeningeal carcinomatosis (LC) is a rare leptomeningeal spread of diffusely metastatic tumors. It occurs more commonly with hematologic tumors, less commonly with solid tumors, and is exceedingly rare in prostate cancer. Due to its scarcity, it has traditionally been difficult to diagnose LC but advancement of MRI has helped considerably. However, even with technological improvements, pre-mortem diagnosis of LC remains difficult and controversial. Our case is a 71-year-old male with prostate cancer with bone metastases who presented to our facility with altered mental status (AMS), lower e

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Monteiro, Ana Margarida, Cláudia Matta-Coelho, Vera Fernandes, and Olinda Marques. "Type 2 Diabetes Decompensation as the Clinical Presentation of Thyroid Storm – Cause or Consequence?" European Endocrinology 13, no. 02 (2017): 99. http://dx.doi.org/10.17925/ee.2017.13.02.99.

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This case study aims to discuss the unusual forms of hyperthyroidism presentation, the nonspecific symptoms and precipitating events. A 70-year-old male was taken to the emergency department for hyperglycaemia, nausea, vomiting and altered mental status with a week of evolution. He had a past medical history of type 2 diabetes, hypertension and dyslipidemia. He had no history of any recent intercurrent illness or infection. At the emergency room, besides hyperglycaemia, ketonemia and slightly elevated C-reactive protein, the basic laboratory panel workup was normal, as was the head computed to

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Murray, Derek, Joshua Olson, and Ana Sofia Lopez. "When the grass isn’t greener: a case series of young children with accidental marijuana ingestion." CJEM 18, no. 6 (2015): 480–83. http://dx.doi.org/10.1017/cem.2015.44.

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AbstractMarijuana is the most commonly used illicit drug in Canada, with 10% of the general population admitting to its use in the past year. This high prevalence increases risk of accidental ingestion in young children.We report four pediatric cases of accidental marijuana ingestion who presented to our local emergency department with altered mental status. Three patients had extensive testing, including one patient who underwent lumbar puncture and empirical treatment for meningitis. To our knowledge, this is the first Canadian case series since McNabb et al., published over 2 decades ago.Th

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Ferri-Guerra, Juliana, Susana Barreiro Sacco, and Alex J. Manzano. "PSAT051 Posterior Reversible Leukoencephalopathy Syndrome Associated With Cushing's Syndrome." Journal of the Endocrine Society 6, Supplement_1 (2022): A110. http://dx.doi.org/10.1210/jendso/bvac150.224.

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Abstract Background Corticosteroids can induce hypertension through a variety of mechanisms such as vasoconstriction, increased hepatic production of angiotensinogen, sympathetic activity, and possible direct cardiotoxic effect. Posterior reversible leukoencephalopathy syndrome (PRES), a syndrome with unclear pathogenesis, can be the consequence of blood pressure elevation in these patients, which can present with headaches, altered consciousness, visual disturbances, or seizures. CASE REPORTA 57-year-old African American woman with a history of hypertension on Lisinopril 40mg as an outpatient

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Hanna, Angy, Inayat Gill, Zaid Imam, Alexandra Halalau, and Laith H. Jamil. "Low yield of head CT in cirrhotic patients presenting with hepatic encephalopathy." BMJ Open Gastroenterology 8, no. 1 (2021): e000609. http://dx.doi.org/10.1136/bmjgast-2021-000609.

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Goals and backgroundThe utility of routine head CT (HCT) in hepatic encephalopathy (HE) evaluation is unclear. We investigated HCT yield in detecting acute intracranial abnormalities in cirrhotic patients presenting with HE.StudyRetrospective review of cirrhotic patient encounters with HE between 2016 and 2018 at Beaumont Health, in Michigan was performed. A low-risk (LR) indication for HCT was defined as altered mental status (AMS), which included dizziness and generalised weakness. A high-risk (HR) indication was defined as trauma/fall, syncope, focal neurological deficits (FNDs) or headache

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Simkhada, Rabindra, Barkadin Khan, and Sanjay Singh KC. "Clinical Profile and Conventional Risk Factors of Acute Coronary Syndrome in Late Elderly Patients." Nepalese Heart Journal 19, no. 2 (2022): 9–12. http://dx.doi.org/10.3126/njh.v20i2.48834.

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Background and Aims: Acute coronary syndrome is an important health issue. There is paucity of its data in late elderly. We aimed to study their clinical profile and prevalence of conventional risk factors. Methods: Descriptive cross-sectional study conducted at Shahid Gangalal National Heart Centre from February 2022 to May 2022 including 71 consecutive patients of acute coronary syndrome of age >75 years. They were evaluated focusing their chief complaints and cardiovascular risk factors. Results: Mean age was 80.32±4.06 years. Forty (56.33%) were male and 31 (43.66%) were fem

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Topno, Roshan Kamal, Krishna Pandey, Niyamat Ali Siddiqui, et al. "An Epidemiological Study of AES (Acute Encephalitis Syndrome) Outbreak 2019 in Muzaffarpur District, Bihar, India." International Journal of TROPICAL DISEASE & Health 46, no. 5 (2025): 14–20. https://doi.org/10.9734/ijtdh/2025/v46i51653.

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Acute encephalitis syndrome (AES) is a major public health concern in India, especially in Muzaffarpur, Bihar, as outbreaks of this neurological disorder have brought on significant morbidity and mortality. It is usually characterized by sudden fever, seizures, confusion, and altered mental status in children along with infectious agents, environmental factors, and malnutrition. It is evident during litchi harvest (April-June), affecting malnourished children from poor families. Among 622 AES cases from May till July 2019; a significant majority were found to have higher mortality and morbidit

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Park, Jong Eun, Sung Yeon Hwang, Ik Joon Jo, et al. "Accuracy of the qSOFA Score and RED Sign in Predicting Critical Care Requirements in Patients with Suspected Infection in the Emergency Department: A Retrospective Observational Study." Medicina 56, no. 1 (2020): 42. http://dx.doi.org/10.3390/medicina56010042.

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Background and objectives: We aimed to compare the accuracy of positive quick sequential organ failure assessment (qSOFA) scores and the RED sign in predicting critical care requirements (CCRs) in patients with suspected infection who presented to the emergency department (ED). Materials and Methods: In this retrospective observational study, we examined adult patients with suspected infection in the ED from June 2018 to September 2018. A positive qSOFA (qSOFA+) was defined as the presence of ≥2 of the following criteria: altered mental status (AMS), systolic blood pressure (SBP) < 100 mmHg

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Owen, Aaron R., Adam W. Amundson, Dirk R. Larson, et al. "Spinal versus general anaesthesia in contemporary primary total knee arthroplasties." Bone & Joint Journal 104-B, no. 11 (2022): 1209–14. http://dx.doi.org/10.1302/0301-620x.104b11.bjj-2022-0469.r2.

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Aims Spinal anaesthesia has seen increased use in contemporary primary total knee arthroplasties (TKAs). However, controversy exists about the benefits of spinal in comparison to general anaesthesia in primary TKAs. This study aimed to investigate the pain control, length of stay (LOS), and complications associated with spinal versus general anaesthesia in primary TKAs from a single, high-volume academic centre. Methods We retrospectively identified 17,690 primary TKAs (13,297 patients) from 2001 to 2016 using our institutional total joint registry, where 52% had general anaesthesia and 48% ha

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Advani, Sonali D., David Ratz, Jennifer K. Horowitz, et al. "Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria." JAMA Network Open 7, no. 3 (2024): e242283. http://dx.doi.org/10.1001/jamanetworkopen.2024.2283.

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ImportanceGuidelines recommend withholding antibiotics in asymptomatic bacteriuria (ASB), including among patients with altered mental status (AMS) and no systemic signs of infection. However, ASB treatment remains common.ObjectivesTo determine prevalence and factors associated with bacteremia from a presumed urinary source in inpatients with ASB with or without AMS and estimate antibiotics avoided if a 2% risk of bacteremia were used as a threshold to prompt empiric antibiotic treatment of ASB.Design, Setting, and ParticipantsThis cohort study assessed patients hospitalized to nonintensive ca

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Petty, Lindsay A., Valerie M. Vaughn, Twisha S. Patel, et al. "1083. Risk Factors Associated with Treatment of Asymptomatic Bacteriuria in the Emergency Department: A Multi-Hospital Cohort Study." Open Forum Infectious Diseases 6, Supplement_2 (2019): S384—S385. http://dx.doi.org/10.1093/ofid/ofz360.947.

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Abstract Background Antimicrobial stewardship interventions to decrease testing and treatment of asymptomatic bacteriuria (ASB) have primarily focused on inpatient clinicians, however emergency medicine (EM) clinicians also test and treat ASB. We identified testing attributable to EM clinicians and patient-level factors associated with EM treatment of ASB. Methods Between November 2017 and March 2019, data were abstracted from medical records of adult non-ICU medical patients at 43 Michigan hospitals admitted through the Emergency Department (ED) with a positive urine culture (Ucx) collected o

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Boutzoukas, Angelique Eleni, Daniel Freedman, W. Garrett Hunt, et al. "1875. La Crosse Virus Neuroinvasive Disease in Children: A Contemporary Review and Evaluation for Predictors of Disease Severity." Open Forum Infectious Diseases 6, Supplement_2 (2019): S47—S48. http://dx.doi.org/10.1093/ofid/ofz359.105.

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Abstract Background La Crosse Virus (LACV) is the most common neuroinvasive arboviral disease in children. Contemporary data on clinical presentation, management, outcomes, and predictors of disease severity are lacking. Methods A retrospective analysis was performed of children (0–18 years) admitted to Nationwide Children’s Hospital from January 2009 to December 2018 diagnosed with LACV neuroinvasive disease (LACV-ND). LACV-ND diagnosis was defined as a compatible clinical illness and serum serologic detection of LACV in the absence of other infectious etiologies. Demographic, clinical, labor

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Advani, Sonali, David Ratz, Jennifer Horowitz, et al. "Prevalence of and risk factors for bacteremic UTIs in hospitalized adults without definitive signs or symptoms of UTI." Antimicrobial Stewardship & Healthcare Epidemiology 3, S2 (2023): s27—s28. http://dx.doi.org/10.1017/ash.2023.251.

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Background: IDSA guidelines recommend withholding treatment in patients with asymptomatic bacteriuria in the absence of systemic signs of infection. However, some patients with bacteriuria may not be able to express symptoms either due to presence of indwelling catheter, underlying complicated urologic anatomy, dementia, or altered mental status (AMS). Clinicians frequently treat bacteriuria in this population with antimicrobial therapy due to concern for sepsis. To determine treatment need, we aimed to review prevalence and risk factors for bacteremic urinary tract infection (UTI) in a cohort

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Brown, Brandon, Kris Mahadeo, Sajad Khazal, et al. "IMMU-52. IMMUNE EFFECTOR CELL ASSOCIATED NEUROTOXICITY (ICANS) AMONG PEDIATRIC AND AYA PATIENTS: MD ANDERSON CANCER CENTER EXPERIENCE." Neuro-Oncology 22, Supplement_2 (2020): ii116. http://dx.doi.org/10.1093/neuonc/noaa215.482.

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Abstract INTRODUCTION Immune effector cell associated neurotoxicity (ICANS) and cytokine release syndrome (CRS) are potentially life-threatening complications associated with immune effector cell (IEC) therapies. We characterize ICANS in pediatric and adult young adolescent (AYA) patients receiving IEC therapy at our institution. METHODS We reviewed clinical characteristics and severity (based on ASTCT Consensus Criteria) in pediatric and AYA patients who received IEC products from 2018–2019 at MDACC. RESULTS Nine patients, median age 15.5 (range: 3–25) years received chimeric antigen receptor

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Brown, Brandon, Paolo Tambaro, Kris Mahadeo, et al. "IMMU-07. IMMUNE EFFECTOR CELL ASSOCIATED NEUROTOXICITY (ICANS) AMONG PEDIATRIC AND AYA PATIENTS: MD ANDERSON CANCER CENTER EXPERIENCE." Neuro-Oncology 22, Supplement_3 (2020): iii361. http://dx.doi.org/10.1093/neuonc/noaa222.363.

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Abstract INTRODUCTION Immune effector cell associated neurotoxicity (ICANS) and cytokine release syndrome (CRS) are potentially life-threatening complications associated with immune effector cell (IEC) therapies. We characterize ICANS in pediatric and adult young adolescent (AYA) patients receiving IEC therapy at our institution. METHODS We reviewed clinical characteristics and severity (based on ASTCT Consensus Criteria) in pediatric and AYA patients with IEC products from 2018–2019 at MDACC. RESULTS Nine patients, median age 15.5 (range: 3–25) years received chimeric antigen receptor (CART)

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Isenberg, Derek L., and Richard Bissell. "Does Advanced Life Support Provide Benefits to Patients?: A Literature Review." Prehospital and Disaster Medicine 20, no. 4 (2005): 265–70. http://dx.doi.org/10.1017/s1049023x0000265x.

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AbstractIntroduction:Emergency medical services have invested substantial resources to establish advanced life support (ALS) programs. However, it is unclear whether ALS care provides better outcomes to patients compared to basic life support (BLS) care.Objective:To evaluate the current evidence regarding the benefits of ALS.Methods:Electronic medical databases were searched to identify articles that directly compared ALS versus BLS care. A total of 455 articles were found. Articles were excluded for the following reasons: (1) the article was not written in English; (2) BLS response was not co

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