OBJECTIVETo promote the study on standardization of attitude of selecting point and posture of nee dling, so as to ensure safety of acupuncture and increase clinical therapeutic effect.

METHODSStudy, analyze and clinically test and verify on literature of past dynasties, and differentiate and analyze differences and significances of attitude of selecting point and posture of needling, indicate the reasonable parts of ancient and modern various theories, and relative contents should be purified, corrected in time, and put forward a proposal on the standardization.

CONCLUSIONAttitude of selecting point and posture of needling have close relation and have a certain difference; the experience of predecessors should be explored and systematized, and present confusion and out-of-date contents should be purified and relative standards should be established as early as possibly.

Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Confusion ; Humans ; Posture ; Reference Standards

PURPOSE: The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital. METHODS: The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n=361) and the results of a pilot study (n=42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC). RESULTS: Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74. CONCLUSION: Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.
Aged ; Aged, 80 and over ; Area Under Curve ; Behavior ; Communication ; Confusion ; Delirium/diagnosis/*nursing ; Female ; Hallucinations ; Hospitals, General ; Humans ; Illusions ; Male ; Pilot Projects ; *Program Development ; Psychomotor Performance ; Questionnaires ; ROC Curve ; Republic of Korea ; Translating

Aged ; China ; Confusion ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Medicine in Literature

INTRODUCTIONPostoperative nausea and vomiting (PONV), and postoperative pain are common during the early postoperative period. In addition to these problems, elderly patients risk developing postoperative confusion. This study aimed to identify the risk factors associated with these problems, and the extent of these problems, in a Singapore inpatient surgical population.

METHODSOver a period of six weeks, we surveyed 707 elective surgical inpatients aged ≥ 18 years who received general anaesthesia and/or regional anaesthesia.

RESULTSThe incidence of PONV was 31.8% (95% confidence interval [CI] 34.8-41.9). The incidence increased with increasing Apfel score (p < 0.001) and were higher in female patients (odds ratio [OR] 1.74, 95% CI 1.28-2.36), non-smokers (OR 1.72, 95% CI 1.04-2.88), patients with a history of PONV and/or motion sickness (OR 3.45, 95% CI 2.38-5.24), patients who received opioids (OR 1.39, 95% CI 1.03-1.88), and patients who received general anaesthesia (OR 1.76, 95% CI 1.11-2.79). Moderate to severe pain at rest and with movement were reported in 19.9% and 52.5% of patients, respectively. Among the patients who were predicted to experience mild pain, 29.5% reported moderate pain and 8.1% reported severe pain. The prevalence of postoperative confusion was 3.9% in the geriatric population.

CONCLUSIONHigher Apfel scores were associated with a higher risk of PONV and multimodal treatment for postoperative pain management was found to be insufficient. The incidence of postoperative confusion was low in this study.

Adult ; Aged ; Aged, 80 and over ; Anesthesia, General ; adverse effects ; Confusion ; chemically induced ; Female ; Humans ; Incidence ; Inpatients ; Male ; Middle Aged ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; chemically induced ; Postoperative Nausea and Vomiting ; chemically induced ; Postoperative Period ; Risk Factors ; Severity of Illness Index ; Sex Factors ; Singapore ; Surveys and Questionnaires ; Young Adult

No abstract available.
Alcohol Withdrawal Delirium* ; Delirium*

No abstract available.
Delirium* ; Sweat* ; Sweating*

Background: Due to the increasing number of elderly patients being referred to anesthesia for surgical procedures, there is a growing interest with regard to the incidence of postoperative delirium and its contributing factors. Objectives: The primary objective of this study is to determine the incidence of postoperative delirium in the charity elderly patients at the Philippine General Hospital (PGH). Methods: The incidence of postoperative delirium was assessed in an analytic prospective study conducted at the PGH among elderly patients undergoing elective surgeries. Through interviews and chart reviews, the collected data focused on baseline intellectual status, age, gender, ASA classification, level of education, comorbidities, vices, previous surgeries, maintenance medications, preoperative diagnostics, duration of surgery, duration of anesthesia, type of anesthetic technique, and pain scores at the recovery room and 24 hours postoperatively. Responses to the Short Portable Mental Status Questionnaire (SPMSQ), the Preoperative and Postoperative assessment forms and the Confusion Assessment Method (CAM) instrument were analyzed. Results: It was observed that there was a 2.5% incidence of postoperative delirium in the study population and among the risk factors assessed, polypharmacy and presence of moderate to severe pain scores on the first day following surgery were significant contributors in its occurrence. Conclusion In this preliminary study, the incidence of postoperative delirium as well as the significant contributing factors were described. In succeeding investigations, it is recommended to extend the observation and follow-up periods.
Emergence Delirium ; Aged ; Incidence

OBJECTIVES: This study developed and validated the Perceived Stigma of Delirium Scale(PSDS), which is designed to measure perceived stigma associated with delirium in patients suffering from that disorder. METHODS: Based on a literature review of scales assessing stigma, a preliminary scale comprising seven items was developed. After recovering from delirium, 128 patients completed the PSDS and the Distress Thermometer (DT). Factor analysis was used to examine construct validity, and internal consistency and test-retest reliability were examined to ensure reliability. Concurrent validity was assessed using the correlation between the total scores on the PSDS and the DT. RESULTS: Factor analysis yielded a single-factor structure from the seven candidate items. One item was excluded due to low factor loading. The internal consistency was computed and Cronbach's α was 0.85 for the total score. The overall test-retest reliability was 0.71, with items ranging from 0.58 to 0.83. The total score on the PSDS was significantly correlated with the DT score. CONCLUSIONS: The PSDS may be a reliable, valid instrument for evaluating perceived stigma in patients who have recovered from delirium. Further study of the perceived stigma by delirium patients is required to assess the implications of the PSDS for clinical practice and research.
Delirium* ; Humans ; Thermometers ; Weights and Measures

No Abstract available.
Anesthetics* ; Delirium* ; Postoperative Nausea and Vomiting*

Injection-related necrosis is a common pattern in the arterial injuries. But the acute embolization that led to extremity necrosis is very rare. Here we described a case of 43-year male patient with arm necrosis due to intra-arterial drug injection. The patient has addicted drug for 24 years and has injected opium for 18 years with dose of 2 ml self-prepared opium solution, 3-4 times daily. On April 2000, after second injection of a day, the patient felt burn and pain in his left hand. Then watery purples and necrotic papules appeared on the skin of left arm. He was treated by antibiotics, analgesics, and vasodilators, but the condition was not improved. The patients had to be amputated his left arm after 3 days of admission.
Substance Withdrawal Syndrome ; Alcohol Withdrawal Delirium ; diagnosis