Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Confusion”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

[Postoperative mental confusion in the elderly with hip fracture. Perioperative risk factors].

OBJECTIVE: To determine the incidence of postoperative mental confusion and perioperative risk factors in elderly patients with femoral neck fractures. PATIENTS AND METHODS: A prospective study of patients 65 years of age or older undergoing surgery for hip fracture with intradural anesthesia between March 1992 and August 1993. Although the total number of cases came to 162, only 50 patients were enrolled in the study: the rest were excluded mainly because of mental deficits presenting before surgery. Folstein's Mini-Mental State test was used to assess mental function. Risk factors analyzed were classified as preoperative, intraoperative (in the operating room and the recovery room) or postoperative (hospital ward). RESULTS: Eleven (22%) patients showed signs of postoperative mental confusion. Simple analysis revealed a correlation between mental confusion and ASA (p = 0.01), neuropsychiatric history (p = 0.03) and preoperative hemoglobulin, red blood cell and urea nitrogen levels (p = 0.02). Multifactorial discriminant analysis indicated that patients with low red cell counts before surgery, high urea nitrogen and neuropsychiatric histories were more predisposed (p = 0.004) to mental confusion. CONCLUSIONS: A high incidence of postoperative mental confusion is associated to pre-surgical factors. We therefore suggest that greater preventive and therapeutic efforts be directed preferably to preparation before surgery, especially in patients at high risk.

Aged↗
PubMedDate not supplied

A study of discomfort and confusion among elderly surgical patients.

Acute confusion is a significant problem among elderly surgical patients, and it can impair the older adult's ability to localize, interpret, or communicate discomfort to care-givers. Discomfort is a common experience for hospitalized older adults, especially those recovering from trauma or surgery. In this study, 36 (78%) of the elderly (> 74 yrs.) patients on an orthopedic/trauma unit were found to be at risk for or acutely confused. Three measures of discomfort were administered to these 36 confused patients by research assistants during routine postoperative nursing activities, such as turning, transfers, or bathing. Acute confusion needs to be viewed as a priority problem for nurses working with elderly surgical patients. Self-report is not a reliable indicator of discomfort in elderly confused patients. It is recommended that health care providers focus on discomfort as they provide care to these elders, and intervene in a preventive fashion.

Acute Disease↗
PubMed1998

Psychotherapeutic agents in older adults. Commonly prescribed and over-the-counter remedies: causes of confusion.

Acute confusion is associated with significant morbidity and mortality among older persons. Among the common causes of confusion, medications are at the top of the list. Since virtually any drug can cause confusion, it is helpful for the clinician to know which patients are at risk and which medications are risky. At particular risk are patients with dementia and patients whose pharmacokinetics or pharmacodynamics have been impaired by the aging process or diseases. The list of medications that can cause confusion is a long one, yet it can be remembered by the mnemonic ACUTE CHANGE IN MS (mental status). In addition to recognizing the offending agent, it is prudent for clinicians to prevent the chance of drug-induced confusion. One of the safest ways to do this is to avoid too many medications since the risk of adverse drug events rises exponentially with the number of medications prescribed.

Age Factors↗
PubMed1998

End-of-life confusion in patients with cancer.

PURPOSE/OBJECTIVES: To review the literature on confusion at the end of life, provide accurate definitional and defining characteristics of confusion, and outline nursing strategies for its resolution. DATA SOURCES: Published articles, computerized databases, book chapters, reference lists from chapters and journal articles. DATA SYNTHESIS: As a major component of symptom distress in terminal care, confusion has not been defined clearly and therefore has not benefited from rigorous assessment and study as have other end-of-life symptoms. CONCLUSIONS: Increased knowledge about confusion that occurs in patients with widely metastatic cancer will assist in accurate symptom identification, early recognition, and timely management to reduce cognitive symptom distress at the end of life. Improved symptom resolution also can benefit family coping during terminal care. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses can devise management protocols for confused patients that include screening criteria, pharmacologic interventions, environmental support, and prophylactic safety measures.

Confusion↗
PubMed2001

The perplexed and confused mutations affect distinct stages during the transition from proliferating to post-mitotic cells within the zebrafish retina.

To identify and study genes essential for vertebrate retinal development, we are screening zebrafish embryos for mutations that disrupt retinal histogenesis. Key steps in retinogenesis include withdrawal from mitosis by multipotent neuroepithelial cells, specification to particular cell types, migration to the appropriate laminar positions, and molecular and morphological differentiation. In this study, we have identified two recessive mutations that affect the transition of proliferating neuroepithelial cells to postmitotic retinal cells. Both the perplexed and confused mutant phenotypes were initially detectable when the first retinal neuroepithelial cells began to leave the cell cycle. At this time, each mutant retina showed increased cell death and a lack of morphological differentiation. Cell death was found to be apoptotic in both perplexed and confused retinas based on TUNEL analysis and activation of caspase-3. TUNEL-phosphoRb-BrdU colocalization studies indicated that the perplexed mutation caused death in cells transitioning from a proliferative to postmitotic state. For the confused mutation, TUNEL-phosphoRb-BrdU analysis revealed that only a subset of postmitotic cells were induced to activate apoptosis. Mosaic analysis demonstrated that within the retina the perplexed mutation functions noncell-autonomously. Furthermore, whole lens or eye cup transplantations indicated that the retinal defect was intrinsic to the retina. Mosaic analysis with confused embryos showed this mutation acts cell-autonomously. From these studies, we conclude that the perplexed and confused genes are essential at distinct stages during the transition from proliferating to postmitotic cells within the zebrafish retina.

Animals↗
PubMed2006

Comparative photophysical properties of free-base, bis-Zn(II), bis-Cu(II), and bis-Co(II) doubly N-confused hexaphyrins(1.1.1.1.1.1).

We have comparatively investigated the photophysics of a series of bis-metal doubly N-confused hexaphyrins(1.1.1.1.1.1) using time-resolved fluorescence, femtosecond transient absorption, two-photon absorption measurements, and geometry-optimized ab initio calculations. Bis-Zn(II) and free-base doubly N-confused hexaphyrins exhibit well-resolved and red-shifted B- and Q-like absorption bands compared with porphyrins. Their allowed transitions are (pi,pi) transitions of the hexaphyrin ring, as confirmed by the HOMO and LUMO frontier orbitals based on ab initio calculations at the B3LYP/6-31G level. On the other hand, the absorption spectra of bis-Cu(II) and bis-Co(II) doubly N-confused hexaphyrins are relatively broad, presumably due to large couplings between the metal d-orbitals and pi-electrons of the hexaphyrin ring. Owing to these couplings, bis-Cu(II) and bis-Co(II) doubly N-confused hexaphyrins have much shorter excited-state lifetimes of 9.4 +/- 0.3 ps and 670 fs, respectively, than those (267 +/- 16 and 62.4 +/- 1.2 ps, respectively) of bis-Zn(II) and free-base doubly N-confused hexaphyrins. The two-photon absorption cross section (sigma(2)) values, which are believed to depend strongly on the ring planarity (pi-conjugation), are in line with the excited-state lifetime trends.

Journal Article↗
PubMed2006

Ultrafast spectroscopy of free-base N-confused tetraphenylporphyrins.

The photophysical characterization of the two tautomers (1e and 1i) of 5,10,15,20-tetraphenyl N-confused free-base porphyrin, as well as the tautomer-locked 2-methyl 5,10,15,20-tetraphenyl N-confused free-base porphyrin, was carried out using a combination of steady state and time-resolved optical techniques. N-Confused porphyrins, alternatively called 2-aza-21-carba-porphyrins or inverted porphyrins, are of great interest for their potential as building blocks in assemblies designed for artificial photosynthesis, and understanding their excited-state properties is paramount to future studies in multicomponent arrays. Femtosecond resolved transient absorption experiments reveal spectra that are similar to those of tetraphenylporphyrin (H2TPP) with either Soret or Q-band excitation, with an extinction coefficient for the major absorbing band of 1e that was about a factor of 5 larger than that of H2TPP. The lifetime of the S1 state was determined at a variety of absorption wavelengths for each compound and was found to be consistent with time-resolved fluorescence experiments. These experiments reveal that the externally protonated tautomer (1e) is longer lived (tau = 1.84 ns) than the internally protonated form (1i, tau = 1.47 ns) by approximately 369 ps and that the N-methyl N-confused porphyrin was shorter lived than the tautomeric forms by approximately 317 ps (DMAc) and approximately 396 ps (benzene). Steady-state fluorescence experiments on tautomers 1e and 1i and the N-methyl analogues corroborate these results, with fluorescence quantum yields (Phi(Fl)) of 0.046 (1e, DMAc) and 0.023 (1i, benzene), and 0.025 (DMAc) and 0.018 (benzene) for the N-methyl N-confused porphyrin. The lifetime and quantum yield data was interpreted in terms of structural changes that influence the rate of internal conversion. The absorption and transient absorption spectra of these porphyrins were also examined in the context of DFT calculations at the B3LYP/6-31G(d)//B3LYP/3-21G(d) level of theory and compared to the spectra/electronic structure of H2TPP and tetraphenyl chlorin.

Molecular Structure↗
PubMed2006

Theoretical investigation of one-photon and two-photon absorption properties for multiply N-confused porphyrins.

We have theoretically investigated a series of multiply N-confused porphyrins and their Zn or Cu complexes for the first time by using DFT(B3LYP/6-31G*) and ZINDO/SOS methods. The electronic structure, one-photon absorption (OPA), and two-photon absorption (TPA) properties have been studied in detail. The calculated results indicate that the OPA spectra of multiply N-confused porphyrins are red-shifted and the OPA intensities decrease compared to normal porphyrin. The maximum two photon absorption wavelengths lambda(max) are blue-shifted and the TPA cross sections delta(max) are increased 22.7-112.1 GM when the N atoms one by one are inverted from core to beta position to form multiply N-confused porphyrins. Especially delta(max) of N3CP get to 164.7 GM. The electron donors -C6F5s at meso-position can make the TPA cross section delta(max) increase. After forming metal complexes with Cu or Zn, the TPA properties of multiply N-confused porphyrins are further increased except for N3CP, N4CP. Our theoretical findings demonstrate that the multiply N-confused prophyrins as well as their metal complexes and derivatives are promising molecules that can be assembled series of materials with large TPA cross section, and are sure to be the subject of further investigation.

Journal Article↗
PubMed1982

Evaluation of hearing-impaired listeners using a Nonsense-syllable Test. II. Syllable recognition and consonant confusion patterns.

Syllable recognition ability and consonant confusion patterns were evaluated for 38 listeners with mild-to-moderate sensorineural hearing loss using the closed-set Nonsense-Syllable Test (NST). Performance for these materials varies as a function of consonant voicing, the position of the consonant in the syllable, and the accompanying vowel. Scores for listeners with steeply sloping audiometric configurations were consistently poorer than those for listeners with gradually sloping or flat audiograms. Consonant confusion analyses revealed place of articulation errors to be the most frequent, regardless of the listener's audiometric configuration. Analysis of consonant confusion patterns indicates the existence of a systematic relationship between consonant confusions and audiometric configuration. The NST findings are discussed in terms of the test's potential use and are compared to the results of existing confusion analyses.

Aged↗
PubMed2001

How crowding affects letter confusion.

BACKGROUND: Acuity for letter recognition is known to be worse when multiple letters are presented with narrow interletter spacings than with wide spacings. How would interletter spacing affect the kind of errors made by human subjects? METHODS: Five-letter strings that were randomly drawn from the 26 uppercase letters of the English alphabet were presented foveally to the subjects. The interletter spacings were 1.0 and 0.1 letter height. Letter confusion matrices were constructed from the data collected using these spacing conditions. RESULTS: Narrow- and wide-spacing letter strings produced different letter confusion matrices. Aside from the letter confusions that were shared by both wide- and narrow-spacing strings, narrow-spacing strings produced more random confusions and a set of unique letter confusions, which was not observed under the wide-spacing condition. CONCLUSION: Increased random guessing and lateral interactions between features of neighboring letters can account for most of the acuity deterioration observed under the narrow-spacing condition.

Adult↗
PubMed1987

Visual hemispheric asymmetry and right-left confusion.

From 357 university students two groups of 8 women each were selected, one group with high right-left confusion and the other without such confusion according to self-reports. Reaction times to stimuli tachistoscopically presented in visual hemifields were recorded to estimate the relationship between perceptual asymmetry and right-left confusion. A significant difference between hemifields and an interaction of hemifield by group appeared, whereas asymmetry in the highly confused group was not so related. According to a model of cerebral functioning in the formation of the body image, these results suggest subjects with high right-left confusion have greater hemispheric bilateralization.

Adolescent↗
PubMed2000

[Investigation on the evolution of the titles of zhen zhu (cinnabar) and zhen zhu (pearl) and its confusion, ancient and modern].

There used to be confusion since ancient time on both zhen zhus. They are two different materials, different from their original materials, nomenclature and dates of their medicinal application. Based on ancient formularies, the two "zhen zhu" were confusedly used to a great extent. The causes of such confusion lie on their exactly identical Chinese pronunciation and the evolution of the Chinese writing characters; both also share some similar functions; and the confusion as recorded by herbological works of successive ages. There are also such confusion in modern books of pharmacy. Points for differentiation of both and conclusion are given here.

China↗
PubMed1996

Memory source confusions: effects of character rotation and sensory modality.

Eighty subjects viewed and visually imagined upright or rotated alphanumeric characters and later judged whether test characters were previously seen or imagined (reality monitoring). Identification and test characters were presented verbally or visually. When characters were identified and tested verbally, source confusions (misjudging a seen character as "imagined" and vice-versa) were infrequent and were comparable for rotated and upright characters. When characters were identified and tested visually, source confusions were more frequent and were influenced by character rotation. Memories for imagined characters were especially susceptible to source confusion. Also source confusions for seen characters increased when characters were rotated. These results are consistent with the proposal that increasing sensory similarity between perceived and imagined items increases source confusion and that perceived rotation generates cognitive operations similar to those generated when the subject imagines a character rotated.

Adult↗
PubMed1999

Acute confusion indicators: risk factors and prevalence using MDS data.

Long-term care (LTC) Minimum Data Set (MDS) data from a Midwestern state were analyzed to validate whether components of a conceptual model developed from findings in acute care identified acute confusion risk variables in LTC. The prevalence of probable acute confusion in this sample was 13.98% (n = 324). Using a cross-sectional design, both univariate and unconditional stepwise logistic regression analyses were accomplished with presence or absence of probable acute confusion as the outcome variable (N = 2,318). Variables significantly related to acute confusion by univariate analysis were included in the logistic regression analysis. Inadequate fluid intake was the first variable to enter the stepwise equation and was highly significant (OR 3.40, 95% CI 2.99-3.81, p < .0001). Other significant variables included a diagnosis of dementia or a fall in the last 30 days. Implications for nursing practice, education and research are discussed.

Acute Disease↗
PubMedDate not supplied

Mental confusion in a patient treated with metronidazole--a concentration-related effect?

We report a case of serious mental confusion, hallucinations, and agitation in a 65 year old man, occurring in close relationship to the intravenous administration of metronidazole. The patient was treated twice, but at different dosages. The confusion and hallucinations occurred at the recommended daily dose of 2.0 g, but did not return at a daily dose of 500 mg. Metronidazole serum concentrations were obtained throughout both courses of therapy; CSF and tissue concentrations were obtained at autopsy. The mental confusion was associated with peak serum concentrations of approximately 40 micrograms/ml. Symptoms resolved within 24-48 hr after stopping metronidazole, and resolution was consistent with a metronidazole half life of 14 hr. We conclude that metronidazole can be associated with a dose- and serum concentration-related mental confusion state, and that this side effect appears completely reversible upon discontinuing the drug.

Aged↗
PubMed1997

The assessment of acute confusion as part of nursing care.

Older adults who become acutely confused when hospitalized present challenges to nurses because of their increased care needs and risk for injury. This study evaluated the feasibility of introducing the NEECHAM Confusion Scale as part of usual nursing care as a first step in improving nurses' ability to assess, prevent, and manage acute confusion in hospitalized older adults. By addressing several of the factors that influence adoption and continuation of a new practice, this study found that staff nurses could successfully use the NEECHAM Confusion Scale.

Acute Disease↗
PubMed1996

Patients' experience of confusion in the intensive care unit following cardiac surgery.

This article reports a study of postoperative intensive care as experienced by coronary artery by-pass patients. The purpose is to describe and reflect upon the patients' experience of confusion in the intensive care unit (ICU). The study was performed according to the phenomenological-hermeneutic research tradition, with ten patients participating. In a free dialogue, the patients were each asked to discuss their experiences in the ICU. The patients remembered their confusion well; it was a significant, incomprehensible experience for them. They felt anxiety while on the threshold between awareness and unawareness, and the fast-paced activity of the ICU environment threatened to draw them into the 'vicious circle' of confusion. In this situation patients emphasised the importance of closeness with a professional person to whom they could turn. The quality of the presence of the nursing staff was significant for the patients, for it was through the true presence of the nurses that patients felt safe, understood and accepted. Patients' comments concerning their confusion verified the challenge this phenomenon poses in nursing care. A research methodology which highlights the individuality of the patients can uncover other hidden or unquestioned issues in nursing. Accordingly, further areas for study are suggested here.

Confusion↗
PubMed2001

The use of source memory to identify one's own episodic confusion errors.

In 4 category cued recall experiments, participants falsely recalled nonlist common members, a semantic confusion error. Errors were more likely if critical nonlist words were presented on an incidental task, causing source memory failures called episodic confusion errors. Participants could better identify the source of falsely recalled words if they had deeply processed the words on the incidental task. For deep but not shallow processing, participants could reliably include or exclude incidentally shown category members in recall. The illusion that critical items actually appeared on categorized lists was diminished but not eradicated when participants identified episodic confusion errors post hoc among their own recalled responses; participants often believed that critical items had been on both the incidental task and the study list. Improved source monitoring can potentially mitigate episodic (but not semantic) confusion errors.

Adult↗