This presentation is about geriatric Psychiatry awareness. it contains basic information about what is geriatric psychiatry, which are the main psychiatry disorder found in elderly and how to manage them?. it contains some detailed information about late life depression, delirium and dementia in geriatric population.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
This presentation is about geriatric Psychiatry awareness. it contains basic information about what is geriatric psychiatry, which are the main psychiatry disorder found in elderly and how to manage them?. it contains some detailed information about late life depression, delirium and dementia in geriatric population.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
Aging is associated with cognitive decline, and older subjects can have demonstrable cognitive impairment without crossing the threshold for dementia.
This condition has been termed “mild cognitive impairment” (MCI), and these patients have an increased risk of developing dementia, especially Alzheimer disease (AD).
Studies conducted in referral clinics have shown that patients with MCI progress to AD at a rate of 10% to 15% per year, and 80% of these patients have converted to AD after approximately 6 years of follow-up.
The identification and classification of MCI can be a major challenge.
John Kane - Treatment-Resistant Schizophrenia: New Guidelines on Diagnosis an...wef
Presentation made at the live webinar hosted by the Schizophrenia Research Forum on the 21st of February, 2017 - http://www.schizophreniaforum.org/forums/treatment-resistant-schizophrenia-new-guidelines-diagnosis-and-terminology
This powerpoint presentation represents definition of the Somatoform disorder, its subtypes, etiology in perspective of theories along differential diagnosis in an attempt to shed light on the disorder adequately
RCPsych09 - Progression of Mild Cognitive Impairment - What To Tell Your Pati...Alex J Mitchell
This is a short 20min presentation on the risk of progression of mild cognitive impairment presented at the Royal College of Psychiatrists June 2009 as invited speaker.
Aging is associated with cognitive decline, and older subjects can have demonstrable cognitive impairment without crossing the threshold for dementia.
This condition has been termed “mild cognitive impairment” (MCI), and these patients have an increased risk of developing dementia, especially Alzheimer disease (AD).
Studies conducted in referral clinics have shown that patients with MCI progress to AD at a rate of 10% to 15% per year, and 80% of these patients have converted to AD after approximately 6 years of follow-up.
The identification and classification of MCI can be a major challenge.
John Kane - Treatment-Resistant Schizophrenia: New Guidelines on Diagnosis an...wef
Presentation made at the live webinar hosted by the Schizophrenia Research Forum on the 21st of February, 2017 - http://www.schizophreniaforum.org/forums/treatment-resistant-schizophrenia-new-guidelines-diagnosis-and-terminology
This powerpoint presentation represents definition of the Somatoform disorder, its subtypes, etiology in perspective of theories along differential diagnosis in an attempt to shed light on the disorder adequately
RCPsych09 - Progression of Mild Cognitive Impairment - What To Tell Your Pati...Alex J Mitchell
This is a short 20min presentation on the risk of progression of mild cognitive impairment presented at the Royal College of Psychiatrists June 2009 as invited speaker.
Teepa Snow, dementia and Alzheimer's care expert, was the guest speaker at a caregiving event sponsored by Home Instead Senior Care of Sonoma County, CA.
This all-day workshop was held on March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. CEU credits were available to attendees which included RPNs.
(c) 2010 TeepaSnow.com. All rights reserved. Use only with permission from Teepa Snow.
Schizophrenia is a serious mental illness that affects how a person thinks, f...AmitSherawat2
Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family a
In 1911, Eugen Bleuler, first used the word "schizophrenia."The word schizophrenia does come from the Greek words meaning "split" and "mind," & refers to the way that people with schizophrenia are split off from reality; they cannot tell what is real and what is not real.
This slide contains information regarding Schizophrenia. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
Personality disorders are conditions in which an individual differs significantly from an average person , in terms of how they think, perceive , feel or relate to others.
Similar to Behavioral and psychological symptoms of dementia (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
2. Introduction:
• Behavioral changes, paranoid
delusions, hallucinations and long periods of
screaming were described by Alzheimer in
1907 in his original case description of the
disease.
• An integral part of dementia syndrome.
• BPSD is associated with a more rapid rate of
cognitive decline and greater impairment in
activities of daily living.
3. • A burden to patients and care givers.
• Costs significantly to overall cost of dementia
care.
• Most of them are treatable.
4. Prevalence:
• Reported prevalence of BPSD ranges from 50%100%.
• BPSD were severe in 36.6% of the
patients, moderate in 49.3%, and mild in 14.1%.
• Depression, apathy and anxiety were the most
common.
• Depending upon cognitive levels, variation in
BPSD frequencies have been reported.
– 92.5% in patients with a MMSE between 11 and 20.
– 84% of the patients with a MMSE between 21 and 30.
5. FEATURES OF BPSD:
• Myriad manifestations.
• Inappropriate behaviors:
– Physically aggressive behavior : hitting, kicking or
biting
– Physically nonaggressive behavior: pacing or
inappropriately handling objects
– Verbally non aggressive agitation: constant
repetition of sentences or requests.
– Verbal aggression: cursing or screaming
6. • 24% and 48% of dementia patients have
motor behavioural abnormalities.
• Physical violence and hitting occurs in
approximately 30% in Alzheimer’s dementia
(AD).
• Predictors of aggressive behavior:
– Premorbid history of aggression
– Troubled premorbid relationship between
caregiver and patient
– Multiple problems.
7. • Wandering:
– Quarter fo AD patients have wandering.
– Elderly wanderers have language impairment,
disorientation and hyperactivity compared to non
wanderers.
– Wanders exhibit better social skills and are less
withdrawn.
• Mood Disturbances:
– Depression is common.
– may not have a typical presentation.
– lack of sad or depressed affect.
8. • Depressive cognitions, death wishes are
common.
• Anxiety, fear, irritability, anger are also seen.
• Apathy : 70-90% of AD.
• Syndrome of decreased initiation and
motivation, decreased social
engagement, emotional
indifference, diminished reactivity and lack of
persistence.
9. • Apathy or Depression?
– Dysphoria, hopelessness, guilt, self-criticism,
suicidal ideation, sleep problems and appetite
disturbances are associated with depression.
• Personality change:
– Increasing passivity, coarsening of affect,
decreased spontaneity, inactivity, feelings of
insecurity, less cheerfulness and responsiveness.
– Reduced initiative and drive, grossly insensitive
behavior, lack of restraint, disinhibition, sexual
misadventure, indolence, foolish jokes and pranks
10. • Psychotic features:
– usually paranoid in nature.
– some one is stealing things, being present in the
room, living inappropriately in the home
(phantom boarder), mishandling personal
finances, planning to harm physically.
– delusions of
infidelity, hypochondriasis, zoopathy, dead
relatives being still alive, erotomania, Capgras
syndrome, believing television images are
real, personal images in a mirror is a different
person, misidentifying own home.
11. • Other symptoms:
– Screaming is seen in 25%.
– high degree of dependency for ADL.
– Sleep disturbance.
– Dependency for excretory functions and hygiene
maintenance come as a burden to caregivers.
12. TYPES OF DEMENTIA AND BPSD:
• Some type of BPSD are more common in
certain type dementia.
• AD:
– Aspontaneity and reduced initiative in early
stages.
– Behavioral symptoms occur ad disease progress.
– Aggression, wandering, incontinence, and at least
one symptom of Klüver-Bucy syndrome was found
in 72%.
13. • DLB:
– Visual hallucinations- more complex, vivid and
rapidly moving.
– Auditory hallucinations, persecutory delusions.
– Fluctuating.
• VaD:
– Judgment and insight is relatively preserved.
– Extreme anxiety and depression.
– Lability and explosive emotional outbursts,
episodes of noisy weeping or laughing
14. • Pick’s dementia:
– Changes of character and social behavior more.
– Fatuous euphoria or apathy,insensitive behavior, lack
of restraint, and sexual misadventure have been seen.
– Hypermetamorphosis occur early than AD.
• Dementia due to Huntington’s disease:
– Emotional disturbance is a prominent premonitory
feature.
– BPSD are reported for some considerable time before
chorea.
– Paranoid developments may be earliest manifestation.
– Delusions of persecution, religiosity, reference and
grandiosity are common.
– schizophrenic or paraphrenic illness may be present
for years before HD.
15. • Creutzfeldt-Jakob disease (CJD):
– characterized by neurasthenic symptoms.
– Fatigue, insomnia, anxiety, depression, mental
– slowness and unpredictability of behavior,
auditory hallucinations and delusions are the
usual complaints.
• Alcoholic dementia:
– Profound social disorganization
– Deterioration of personality.
16. ETIOLOGY OF BPSD:
• Various theoretical models have been
proposed.
• ‘Unmet needs’ model
• A behavioral/learning model
• Environmental vulnerability/reduced stressthreshold model.
• Premorbid personality has also been linked to
BPSD.
17. • It has been suggested that some BPSD could
be the consequence of both dementia and an
undiagnosed comorbid bipolar spectrum
disorder or a pre-existing bipolar diathesis
pathoplastically altering the clinical expression
of dementia.
18.
19. • An imbalance of different neurotransmitters
(acetylcholine, dopamine, noradrenaline, sero
tonin,GABA) has been proposed as the
neurochemical correlate of BPSD.
– increased norepinephrine (NE) activity and/or
hypersensitive adrenoreceptors compensating for
loss of NE neurons – in AD
– Increased activity of dopaminergic
neurotransmission and altered serotonergic
modulation of dopaminergic neurotransmission is
associated with agitated and aggressive behavior
in FTD.
20. • DAT1 3’-UTR VNTR polymorphism may play a
role in BPSD susceptibility.
21. ASSESSMENT:
• Depends on history from care giver.
• Specific assessment scales are available.
– Apathy Evaluation Scale (AES)
– Behavioural Rating Scale for Geriatric Patients
– Behaviour Pathology in Alzheimer’s Disease Rating Scale (BEHAVEAD)
– Behavioural Rating Scales for Dementia
– Cohen-Mansfield Agitation Inventory (CMAI)
– Cornell Scale for Depression in Dementia (CSDD)
– Frontal Systems Behaviour Inventory (FrSBe)
– Neuropsychiatric Inventory (NPI)
– Neuropsychiatric Inventory– Nursing Home version (NPI-NH)
– Apathy Inventory (AI)
– Behavioural and Psychological Symptoms Questionnaire (BPSQ).
22. MANAGEMENT OF BPSD:
• Psychological, behavioral, environmental, and
pharmacological interventions.
• Nonpharmacological intervention is the
preferred initial method of intervention for
BPSD.
24. Environmental modifications:
• Environment around the patient can be modified
for a beneficial effect on the BPSD.
• Simulated home environment with appropriate
visual, auditory and olfactory stimuli which may
decrease the chance of trespassing, exit seeking
and other agitation behaviors.
• Reduced stimulation environments.
• Environment can be modified by installing
adequate daytime lighting to improve sleep
patterns in patients with disturbed sleep wake
cycles.
25. Social interactions:
• One to one interaction for 30 min per day for
10 days has been found to be effective in
decreasing verbally disruptive behavior.
• Regular intensive interaction help in reality
orientation.
• Socialization can be increased by group
activity, conjoint tasks and simple games.
• Displaying photos of near relatives.
• Pet therapy.
26. Minimize the impact of sensory
deficits:
• Corrective eyeglasses and hearing aids
decrease risk of disorientation.
• Slow and repetitive explanations reduce
confusion and agitation.
27. Medical and nursing interventions:
• Prompt management of pain is helpful.
• Adequate sleep hygiene – decreases agitation.
• Agitation secondary to fatigue and circadian
rhythm disturbances can be reduced by bright
light therapy.
• Music therapy has been shown to be effective
to reduce BPSD in patients with moderatesevere dementia.
28. Behavioral interventions:
• Extinction, differential reinforcement and
stimulus control.
• Reinforcements include social
reinforcements, food, touch, going
outside, etc.
• Consistent daily routines.
• Exercises, removal of restraints, and adequate
rest help in reducing the inappropriate
behavior.
• Spiritual and religious activities.
32. References:
• Nilamadhab Kar; Behavioral and psychological symptoms of
dementia and their management; Indian J Psychiatry. 2009
January; 51(Suppl1): S77–S86.
• Manjari Tripathi, Deepti Vibha; An approach to and the
rationale for the pharmacological management of behavioral
and psychological symptoms of dementia; IAN 2010; 9
• Franz Müller-Spahn,MD; Behavioral disturbances in
dementia.
• Bradley's Neurology in Clinical Practice, 6th edition