Abstract:
OBJECTIVES:To explore factors that might contribute to misattribution of mental status changes to psychiatric illness when an elderly patient actually has a delirium (mental status changes due to a medical condition). METHODS:Records of 900 elderly patients referred to a Veterans Affairs psychiatric inpatient unit and 413 to an inpatient psychiatric team at a public hospital from 2001 to 2007 were reviewed. Cases referred because of symptoms secondary to an unrecognized delirium underwent further analysis of preadmission assessments. Comparisons were made to elderly patients with delirium appropriately admitted to medical units. RESULTS:Thirty (2.3%) of the patients referred to psychiatric units were found to have a physical disorder requiring medical intervention within twelve hours. Compared to 30 delirious patients admitted to medical units, those inappropriately referred to psychiatric units had significantly lower rates of adequate medical histories, physical examinations, cognitive assessments, and laboratory/radiological studies. Among patients with delirium referred to psychiatric units, 66.7% had a history of mental illness, versus 26.7% of comparable admissions to medical units (chi (7) = 60.00, P < 0.001). CONCLUSIONS:Our findings suggest that elderly patients with delirium admitted to psychiatric units are less likely to undergo complete diagnostic assessments than delirious elderly patients admitted to medical units. Symptoms of delirium appear more likely to be incorrectly attributed to psychiatric illness in patients with a history of mental illness than in patients without such a history. Possible explanations for these findings and suggestions for addressing these issues are offered.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Reeves RR,Parker JD,Burke RS,Hart RHdoi
10.1097/SMJ.0b013e3181c99423subject
Has Abstractpub_date
2010-02-01 00:00:00pages
111-5issue
2eissn
0038-4348issn
1541-8243journal_volume
103pub_type
杂志文章abstract::Seven patients with diabetes of ten to 24 years' duration and renal insufficiency were treated with fluphenazine and amitriptyline in an attempt to control severe pain in the extremities. Six patients had relief of pain within five days of initiation of therapy. One patient had no pain relief despite mood alteration. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::Poisoning by antimony led to the death of a great individual in English literature. This case report gives as much of the history of the illness as can be found and tells a little about the individual. ...
journal_title:Southern medical journal
pub_type: 传,历史文章,杂志文章
doi:10.1097/00007611-198205000-00021
更新日期:1982-05-01 00:00:00
abstract::Between October 1977 and 1978, 93 CutterCast casts were applied at the Veterans Administration Hospital in Atlanta, Georgia. The composition and application of this new casting system are described, and the performance of the 93 casts is evaluated in relation to ease of application, roentgenographic clarity, skin cond...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198005000-00007
更新日期:1980-05-01 00:00:00
abstract::Six patients with classical transient ischemic attacks that were not directly related to extracranial carotid disease are presented. These cases were selected to include a variety of pathologic conditions: one case each of brain tumor, arteriovenous malformation, chronic subdural hematoma, cervical spondylosis, and tw...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197606000-00015
更新日期:1976-06-01 00:00:00
abstract::Mesenteric lipodystrophy (ML) is a rare condition characterized by a nonspecific inflammatory process that involves the root of the mesentery in a lipoma-like lesion. Presenting features of ML include abdominal pain, weight loss, nausea, vomiting, diarrhea, and constipation. This case illustrates that ML should be inc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199905000-00013
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVES:Non-small-cell lung cancer (NSCLC) patient survival depends on a number of factors, including early diagnosis and initiation of treatment. Standard treatment options for patients with NSCLC include surgery, radiation therapy, and chemotherapy. The objective of this study was to evaluate the impact that the i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000601
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:: Bronchus-associated Lymphoid Tissue (BALT) lymphomas are a rare type of extranodal marginal zone lymphomas. They comprise 1% of lymphomas and more than two-thirds of all primary non-Hodgkin lymphoma (NHL) of the lung. BALT lymphomas arise from the bronchus-associated lymphoid tissue. METHODS:This report d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181bfdd2d
更新日期:2009-12-01 00:00:00
abstract::A patient with a large paraesophageal hernia had a Nissen fundoplication via laparoscopy. He returned a year later with the transverse colon herniated into the chest. At operation, the hernia ostium was found to be the aortic hiatus. We believe that the original ostium was missed because of the limited exposure of the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199703000-00016
更新日期:1997-03-01 00:00:00
abstract::I have reported three case of paraurethral cysts in female neonates. These are uncommon lesions, and urologic evaluation is required to differentiate them from ectopic ureteroceles, urethral diverticula, or paraurethral tumors. Histologic appearance of the cyst epithelium identifies the embryologic origin. The cysts e...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198506000-00035
更新日期:1985-06-01 00:00:00
abstract::Pulmonary involvement with non-Hodgkin's lymphoma, while well recognized, is less common than with Hodgkin's lymphoma. Endobronchial non-Hodgkin's lymphoma is even rarer and usually occurs in the presence of disseminated disease. We present a case of bilateral endobronchial non-Hodgkin's lymphoma. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199503000-00025
更新日期:1995-03-01 00:00:00
abstract::We have described a patient with a biopsy-proven mucoepidermoid carcinoma of the orbit. Although it may have represented a metastasis from a malignancy of the upper respiratory tract, clinically it appeared to be a primary neoplasm of the lacrimal gland. This case emphasizes the value of transmission electron microsco...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198905000-00027
更新日期:1989-05-01 00:00:00
abstract::The rapid increase in the use of helicopters for hospital transport during the 1980s is the culmination of several hundred years of military medical innovation. Mass battefield casualties spurred both technologic and medical changes necessary for today's sophisticated helicopter systems in use worldwide, particularly ...
journal_title:Southern medical journal
pub_type: 历史文章,杂志文章
doi:10.1097/00007611-198907000-00022
更新日期:1989-07-01 00:00:00
abstract::We studied etiologic factors important in colonization of 179 central venous catheters (CVCs) in patients randomized into group 1 (who received daily topical applications of povidone-iodine) or group 2 (who received only dry dressing changes). Colonization rates of CVC tips were similar between group 1 (18/84 or 21%) ...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007611-198404000-00012
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVES:The need for colonoscopy is common among diabetic patients. However, there are no standards per se for bowel preparation in patients with type 2 diabetes. In this study, we evaluated the efficacy, safety, and tolerability of sodium phosphate (NaP), and the quality of bowel cleansing in relation to glycemic c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181f20b13
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To assess the effect of a positive urine screen for cocaine on thyrotropin (TSH, also thyroid-stimulating hormone) concentrations. METHODS:In this retrospective cohort study, patients admitted to the mental health unit at an academic inpatient setting with a diagnosis of cocaine dependence or cocaine intoxic...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000239
更新日期:2015-02-01 00:00:00
abstract::Thirty-two patients with a resectable mass in the head of the pancreas had pancreaticoduodenectomy for suspected or proven cancer. Twenty-eight proved to have cancer (15 periampullary and 13 pancreatic), and four had pancreatitis. The five-year survival for periampullary and pancreatic cancer was 25% and 0%, respectiv...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198509000-00007
更新日期:1985-09-01 00:00:00
abstract::Diabetic peripheral neuropathy affects 5 to 50% of people with diabetes in the United States. It is a progressive disorder that results in a gradual decrease in peripheral sensation and eventually complete loss of sensation. Patients with diabetic peripheral neuropathy are challenging to treat because of intolerable a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000060886.57804.2E
更新日期:2003-06-01 00:00:00
abstract::Most regions of the United States are served by poison control centers that provide 24-hour toxicologic guidance resulting in the home management of most poison exposures. It has been suggested that without public access to a poison control hotline the majority of poison-exposed patients would seek medical care in eme...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::We report a case of acute appendicitis with perforation associated with retained appendiceal barium. Abnormally retained barium may lead to appendicitis and this should be kept in mind when a barium-filled appendix is seen in an asymptomatic patient. Routine follow-up films on all patients whose appendix fills with ba...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198204000-00037
更新日期:1982-04-01 00:00:00
abstract::We reviewed 91 cases of neonatal necrotizing enterocolitis (NNEC), which continues to be a devastating disease occurring in 2% to 4% of all newborn intensive care unit admissions. Onset now occurs in older infants (11.9 days). The morbidity is significant (22%), with strictures (8%) and recurrences (8%) the primary pr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198411000-00010
更新日期:1984-11-01 00:00:00
abstract::I report my experience during one 6-month period as the sole rheumatologist running a weekly clinic at a small community hospital. The report illustrates the impact of rheumatologic expertise in an environment well-served by generalists and other medical subspecialists. This experience identifies important gaps in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199503000-00004
更新日期:1995-03-01 00:00:00
abstract::We have described a patient with vaccinia necrosum after smallpox vaccination for persistent herpes labialis. The patient eventually recovered after surgical resection of the lesion and multiple courses of vaccinia immune globulin and methisazone. This report emphasizes the needless risks of vaccinating patients with ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198103000-00044
更新日期:1981-03-01 00:00:00
abstract::We have described two cases of spontaneous intracerebral hematoma, characterized by sedimentation level seen on unenhanced cerebral CT, in patients receiving anticoagulation therapy. Anticoagulation or coagulopathy may be important in producing sedimentation levels. The "sedimentation level" is a more accurate term th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199310000-00020
更新日期:1993-10-01 00:00:00
abstract::The cost of managing chronic ulcers, both venous leg and decubiti (sacral pressure), was reviewed using 36 randomized, controlled studies with a focus on saline, hydrocolloid, and a human skin construct. When one includes the labor intensiveness of dressing changes three to four times per day, the application of hydro...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000082011.70728.8C
更新日期:2004-02-01 00:00:00
abstract::Intravesical BCG (bacillus Calmette-Guérin) instillation is a first-line treatment for superficial transitional cell carcinoma of the bladder. A rare but severe complication of BCG immunotherapy is the development of disseminated BCG disease, which can result in miliary pneumonitis, granulomatous hepatitis, soft tissu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31815d4047
更新日期:2008-01-01 00:00:00
abstract::Abscess of the spleen is uncommon and potentially lethal, but until recently it was rarely diagnosed except by exploratory celiotomy or at autopsy. Now, with the advent of radionuclide scanning, ultrasonography, and selective angiography, earlier diagnosis is possible in most cases. We report a case of traumatic absce...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197905000-00019
更新日期:1979-05-01 00:00:00
abstract::Twenty-eight women were tested with a standard three-hour oral glucose tolerance test before and after three years of using a combination-type oral contraceptive containing mestranol and ethynodiol diacetate (Ovulen). At the three-year test time there was a significant elevation of the patients' weights and their 1-, ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197710000-00010
更新日期:1977-10-01 00:00:00
abstract::Gaseous distention of the stomach at the time of arteriography enhances the contrast of densities within the pancreatic parenchyma, resulting in excellent visualization and therefore precise preoperative localization of insulin-secreting tumors of the pancreas. This relatively simple modification of selective arteriog...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198312000-00017
更新日期:1983-12-01 00:00:00
abstract::Sleep loss impairs ventilatory responsiveness to hypercapnia and hypoxia, and also interferes with performance on spirometry. To test the hypothesis that the decline in hypercapnic drive due to sleep loss is mediated by endorphin production, we measured loaded and unloaded CO2 response after injection of placebo and n...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-198701000-00004
更新日期:1987-01-01 00:00:00
abstract::Pregnancy in patients who have non-Hodgkin's lymphoma is unusual. We have reported a case of diffuse, poorly differentiated lymphocytic lymphoma, stage IIIa, in a patient whose disease went into remission after she received six courses of CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone). She...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198510000-00032
更新日期:1985-10-01 00:00:00