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Adam Shiroff - One of the best experts on this subject based on the ideXlab platform.
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Case Report Repetitive Myocardial Infarctions Secondary to Delirium Tremens
2016Co-Authors: David Schwartzberg, Adam ShiroffAbstract:Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Delirium Tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of Delirium Tremens, that is, propofol. We report a trauma patient who required propofol sedation for Delirium Tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for Delirium Tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of Delirium Tremens and adds to the literature on the instability patients experience during withdrawal. 1
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Repetitive myocardial infarctions secondary to Delirium Tremens.
Case reports in critical care, 2014Co-Authors: David Schwartzberg, Adam ShiroffAbstract:Delirium Tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of Delirium Tremens, that is, propofol. We report a trauma patient who required propofol sedation for Delirium Tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for Delirium Tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of Delirium Tremens and adds to the literature on the instability patients experience during withdrawal.
Arnont Vittayanont - One of the best experts on this subject based on the ideXlab platform.
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Delirium Tremens in psychiatric ward at songklanagarind hospital
Journal of Health Science and Medical Research, 2018Co-Authors: Teerapat Teetharatkul, Arnont VittayanontAbstract:Objectives: To examine the epidemiology of Delirium Tremens patients in the psychiatric ward at Songklanagarind Hospital and to find factors associated with the disease. Material and Methods: This was a cross-sectional study that collected data from alcohol dependent patients who were admitted in the psychiatric ward at Songklanagarind Hospital between January 2011 and December 2014. Descriptive statistics were used to analyze the data and logistic regression analysis used to analyze factors associated with the disease. Results: The prevalence of Delirium Tremens in psychiatric ward was 28.0%. The study found that body temperature >37.8 °C (p-value=0.026), eosinophils >6.0% (p-value=0.046), hematocrit 97 g/dl (p-value 33 pg (p-value 1 mg/dl (p-value= 0.039) and direct bilirubin >0.2 mg/dl (p-value=0.036) were significant factors correlated with Delirium Tremens. Multiple logistic regression models found that only red blood cell count <4.5x106/ul (p-value<0.001) was a significant factor correlated with Delirium Tremens. Conclusions: The prevalence of Delirium Tremens in this study was lower than in other Asian countries. Red blood cell count <4.5x106/ul (p-value<0.001) was correlated with Delirium Tremens.
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Delirium Tremens in Psychiatric Ward at Songklanagarind Hospital
Journal of Health Science and Medical Research, 2018Co-Authors: Teerapat Teetharatkul, Arnont VittayanontAbstract:Objectives: To examine the epidemiology of Delirium Tremens patients in the psychiatric ward at Songklanagarind Hospital and to find factors associated with the disease. Material and Methods: This was a cross-sectional study that collected data from alcohol dependent patients who were admitted in the psychiatric ward at Songklanagarind Hospital between January 2011 and December 2014. Descriptive statistics were used to analyze the data and logistic regression analysis used to analyze factors associated with the disease. Results: The prevalence of Delirium Tremens in psychiatric ward was 28.0%. The study found that body temperature >37.8 °C (p-value=0.026), eosinophils >6.0% (p-value=0.046), hematocrit 97 g/dl (p-value 33 pg (p-value 1 mg/dl (p-value= 0.039) and direct bilirubin >0.2 mg/dl (p-value=0.036) were significant factors correlated with Delirium Tremens. Multiple logistic regression models found that only red blood cell count
Takefumi Suzuki - One of the best experts on this subject based on the ideXlab platform.
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a possible role of takotsubo cardiomyopathy in ventricular fibrillation during Delirium Tremens a case report and literature review
Psychosomatics, 2017Co-Authors: Takuto Ishida, Hiroyuki Uchida, Kazuki Miyazaki, Takahiro Yukawa, Kazuhiro Sugiyama, Yuuichi Hamabe, Masaru Mimura, Takefumi SuzukiAbstract:Introduction Takotsubo cardiomyopathy is characterized by acute and transient apical ventricular dysfunction in the absence of significant obstructive coronary artery disease and is assumed to be caused by excessive catecholamines release. We report on a 57-year-old male who presented with Takotsubo cardiomyopathy during Delirium Tremens that resulted from alcoholism. Laboratory examination revealed hypokalemia and hypomagnesemia. ECG revealed marked QT prolongation and he developed ventricular fibrillation (Vf) after torsade de pointes (TdP), which was successfully treated with immediate defibrillation. Method We searched articles related to Takotsubo cardiomyopathy complicated with alcohol withdrawal using Embase and PubMed. Results There have been 11 case reports of Takotsubo cardiomyopathy associated with alcohol withdrawal thus far. Of these reports, 6 patients had symptoms consistent with Delirium Tremens, 1 patient with possibly Delirium Tremens, and 2 patients experienced withdrawal seizure. Of these 9 patients with severe alcohol withdrawal symptoms, 7 patients developed heart failure, 6 patients exhibited QT prolongation in ECG, and 1 patient suffered TdP and Vf. Conclusion The patients who suffered from Delirium Tremens complicated with Takotsubo cardiomyopathy may have a high risk of TdP and Vf because of QT prolongation due to Takotsubo cardiomyopathy and electrolyte disturbances associated with alcohol withdrawal. Considering high fatality of this condition, clinicians need to be on alert for Takotsubo cardiomyopathy as a possible complication of Delirium Tremens; serial 12-lead ECGs and TTEs should be performed appropriately in response to the abnormal findings. Systematic survey on the incidence of Takotsubo cardiomyopathy among patients with Delirium Tremens is warranted.
Anil Batra - One of the best experts on this subject based on the ideXlab platform.
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Diagnostics and therapy of alcohol withdrawal syndrome: focus on Delirium Tremens and withdrawal seizure
Psychiatrische Praxis, 2010Co-Authors: Ulrich C. Lutz, Anil BatraAbstract:INTRODUCTION Delirium Tremens and withdrawal seizures are serious complications of an alcohol withdrawal syndrome. This review presents the diagnostic procedures required in case of the occurrence of a withdrawal seizure and Delirium Tremens as well as possible treatment options including prophylactic medication regimen for alcohol withdrawal syndrome. Furthermore non-pharmacological procedures accompanying Delirium Tremens and a potential integration of viewing videotapes of Delirium Tremens in the course of alcohol-specific therapy are discussed. METHODS A systematic literature research using Pubmed has been carried out to find recent studies and review articles dealing with alcohol withdrawal syndrome. RESULTS AND DISCUSSION Regarding the diagnostic algorithm in case of the occurrence of a withdrawal seizure or a Delirium Tremens basic diagnostic procedures and special diagnostics including neuro-imaging or cerebrospinal fluid puncture depending on patients' clinical condition have to be considered. Sedatives are important in treatment of alcohol withdrawal seizures and Delirium Tremens as well as in the prophylaxis of alcohol withdrawal syndrome. A long-lasting prescription of anticonvulsant medication in patients suffering from withdrawal seizure should be considered critically and can be carried out only under certain conditions.
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Diagnostics and therapy of alcohol withdrawal syndrome: focus on Delirium Tremens and withdrawal seizure
Psychiatrische Praxis, 2010Co-Authors: Ulrich C. Lutz, Anil BatraAbstract:Delirium Tremens and withdrawal seizures are serious complications of an alcohol withdrawal syndrome. This review presents the diagnostic procedures required in case of the occurrence of a withdrawal seizure and Delirium Tremens as well as possible treatment options including prophylactic medication regimen for alcohol withdrawal syndrome. Furthermore non-pharmacological procedures accompanying Delirium Tremens and a potential integration of viewing videotapes of Delirium Tremens in the course of alcohol-specific therapy are discussed. A systematic literature research using Pubmed has been carried out to find recent studies and review articles dealing with alcohol withdrawal syndrome. Regarding the diagnostic algorithm in case of the occurrence of a withdrawal seizure or a Delirium Tremens basic diagnostic procedures and special diagnostics including neuro-imaging or cerebrospinal fluid puncture depending on patients' clinical condition have to be considered. Sedatives are important in treatment of alcohol withdrawal seizures and Delirium Tremens as well as in the prophylaxis of alcohol withdrawal syndrome. A long-lasting prescription of anticonvulsant medication in patients suffering from withdrawal seizure should be considered critically and can be carried out only under certain conditions.
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Das Alkoholentzugssyndrom: Delirium Tremens und Krampfanfall
Suchttherapie, 2010Co-Authors: Ulrich C. Lutz, Anil BatraAbstract:Ziel: Gravierendste, lebensbedrohliche Komplikationen des Alkoholentzugssyndroms sind Entzugskrampfanfall und Delirium Tremens. Die Ubersichtsarbeit stellt die typische Symptomatik, sich aus der Anamnese ergebende Risikofaktoren, atiologisch relevante neurobiologische Faktoren sowie den Versuch der Identifikation von Biomarkern inklusive genetischer Polymorphismen fur das Delirium Tremens und den Alkoholentzugskrampfanfall vor. Methodik: Es erfolgte eine systematische Literaturrecherche mit Hilfe der Datenbank Pubmed unter Auswahl aktueller Studien und Ubersichtsarbeiten zu dem Thema. Ergebnisse: Aktuelle neurobiologische Modelle favorisieren eine gesteigerte glutamaterge und reduzierte GABAerge Transmission als Grundlage fur eine zerebrale Hyperexzitabilitat. Als Risikofaktoren fur die Entstehung eines Delirium Tremens und eines Entzugskrampfanfalls wurden serologische und genetische Faktoren identifiziert. Bei den genetischen Faktoren handelt es sich um Polymorphismen innerhalb von Kandidatengenen insbe...
David Schwartzberg - One of the best experts on this subject based on the ideXlab platform.
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Case Report Repetitive Myocardial Infarctions Secondary to Delirium Tremens
2016Co-Authors: David Schwartzberg, Adam ShiroffAbstract:Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Delirium Tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of Delirium Tremens, that is, propofol. We report a trauma patient who required propofol sedation for Delirium Tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for Delirium Tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of Delirium Tremens and adds to the literature on the instability patients experience during withdrawal. 1
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Repetitive myocardial infarctions secondary to Delirium Tremens.
Case reports in critical care, 2014Co-Authors: David Schwartzberg, Adam ShiroffAbstract:Delirium Tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of Delirium Tremens, that is, propofol. We report a trauma patient who required propofol sedation for Delirium Tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for Delirium Tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of Delirium Tremens and adds to the literature on the instability patients experience during withdrawal.