Delirium is also known as acute confusional state, altered mental status, and toxic metabolic encephalopathy, among more than 30 descriptive terms. Delirium can be thought of as acute brain failure and is the final common pathway of multiple mechanisms, similar to acute heart failure. The official definition of delirium in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), requires a disturbance in attention and awareness that develops acutely and tends to fluctuate. The pathophysiological mechanisms of delirium remain poorly understood; leading models include neurotransmitter imbalance and neuroinflammation.
Kurtzke’s Expanded Disability Status Scale (EDSS)
The Expanded Disability Status Scale (EDSS), an accepted method of quantifying disability in Multiple Sclerosis (MS) consists of an eight-function system scale monitoring motor, sensory, cerebellar, brain stem, visual, bowel and bladder, pyramidal and other functions.
Comparative Effectiveness of Statin Therapy
HMG CoA-reductase inhibitors or statins are clearly the most effective class of drugs for lowering LDL cholesterol. Those drugs have been associated with a beneficial impact on cardiovascular morbidity and mortality.
Diagnostic Criteria for Anaphylaxis
Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death; it involves multiple organ systems, including the respiratory tract, gastrointestinal tract, and skin.
Diagnosis of Porphyria
The porphyrias are disorders of heme synthesis, which has eight steps. Each type of porphyria involves a defect, either inherited or acquired, in a pathway enzyme. When the defect is physiologically significant, it results in overproduction of pathway precursors preceding the defective step which enter the circulation and are excreted into urine or bile. The diseases have been grouped as acute hepatic porphyrias and photocutaneous porphyrias. The acute porphyrias are due to hepatic overproduction of the porphyrin precursors, delta aminolevulinic acid and porphobilinogen, and the symptoms are caused by injury primarily to the nervous system. Cutaneous porphyria is due to overproduction of photosensitizing porphyrins by the liver or bone marrow, depending on the type of porphyria.
Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS)
The Berlin definition, proposed in 2012, breaks with tradition by establishing three risk strata that are based on the degree of hypoxemia as assessed at a minimum positive end-expiratory pressure (PEEP).
Comparative Efficacy and Safety of the Angiotensin Receptor Blockers (ARBs)
The appearance of angiotensin receptor blockers (ARBs) amongst the therapeutic options in the treatment of cardiovascular diseases (CVDs) was a new milestone in the history of hypertension treatment. It further widened the range of possibilities for personalized therapy, especially for patients who cannot tolerate the use of angiotensin converting enzyme inhibitors (ACEIs).
Diagnostic Criteria for Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) is a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock, typically involving disturbance of sleep and constant vivid recall of the experience, with dulled responses to others and to the outside world.
Spetzler–Martin Grading Scale for Arteriovenous Malformations of the Brain
Arteriovenous malformations of the brain are congenital anomalies of the blood vessels that are derived from maldevelopment of the capillary network, allowing direct connections between cerebral arteries and veins. The most common presenting symptoms are cerebral hemorrhage and seizures. Focal neurologic deficits and headaches may develop independent of cerebral bleeding. As a result of the widespread use of brain imaging, arteriovenous malformations are increasingly being discovered incidentally.
Classification of Hypoglycemia
Hypoglycemia is the major limiting factor in the glycemic management of type 1 and type 2 diabetes. Recommendations from the International Hypoglycaemia Study Group regarding the classification of hypoglycemia considers a blood glucose <54 mg/dL (3.0 mmol/L) detected by self-monitoring of blood glucose (SMBG), continuous glucose monitoring (CGM) (for at least 20 min), or laboratory measurement of plasma glucose as sufficiently low to indicate serious, clinically significant hypoglycemia that should be included in reports of clinical trials of glucose-lowering drugs for the treatment of diabetes. However, a glucose alert value of </=70 mg/dL (3.9 mmol/L) can be important for therapeutic dose adjustment of glucose-lowering drugs in clinical care and is often related to symptomatic hypoglycemia. Severe hypoglycemia is defined as severe cognitive impairment requiring assistance from another person for recovery.