Database : MEDLINE
Search on : Wernicke and Encephalopathy [Words]
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[PMID]: 29286589
[Au] Autor:Guirguis M; Manning S; Chavez M; Nelson J; Baronia R; Bobba S; Ahmed J; Ajufo I
[Ad] Address:Department of Psychiatry, Texas Tech University Health Sciences Center, 3601 4th St Stop 8103, Lubbock, TX 79430. medhat74@yahoo.com.
[Ti] Title:Are Psychiatric Inpatients at Risk of Developing Wernicke's Encephalopathy Being Identified and Adequately Treated?
[So] Source:Prim Care Companion CNS Disord;19(6), 2017 Dec 28.
[Is] ISSN:2155-7780
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Objective: Wernicke's encephalopathy is caused by thiamine deficiency and occurs predominantly in alcohol-dependent individuals but also develops in those who are malnourished due to other reasons including medical and psychiatric disorders. This study examined the frequency rate and management of Wernicke's encephalopathy in alcohol-dependent and non-alcohol-dependent patients admitted to a psychiatric hospital. Methods: Data were retrospectively collected from electronic medical records of psychiatric inpatients admitted to a teaching hospital located in Texas between September 2013 and March 2014. The diagnostic criteria of Caine and colleagues and thiamine dosing strategies were used to identify cases of suboptimal management. Results: A total of 486 charts were reviewed. Nine patients (1.85%) had clinical signs of Wernicke's encephalopathy, and 36 (7%, n = 486) were at a high risk for developing the disorder. None of these patients received adequate doses of parenteral thiamine, and of those who were prescribed thiamine, the majority, including high-risk patients, were prescribed oral thiamine at the traditional dose of 100 mg/d. Conclusions: The findings suggest that Wernicke's encephalopathy is underdiagnosed and undertreated. Our study also highlights the need for clarifying diagnostic criteria, identifying the risk factors for thiamine deficiency, and improving awareness among physicians about diagnosis, prevention, and adequate treatment of Wernicke's encephalopathy in alcohol-dependent and non-alcohol-dependent patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process

  2 / 2114 MEDLINE  
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[PMID]: 29482863
[Au] Autor:Nakamura ZM; Tatreau JR; Rosenstein DL; Park EM
[Ad] Address:Department of Psychiatry, University of North Carolina, Chapel Hill, NC. Electronic address: zev.nakamura@unchealth.unc.edu.
[Ti] Title:Clinical Characteristics and Outcomes Associated With High-Dose Intravenous Thiamine Administration in Patients With Encephalopathy.
[So] Source:Psychosomatics;, 2018 Jan 11.
[Is] ISSN:1545-7206
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Wernicke encephalopathy is a common neuropsychiatric syndrome due to thiamine deficiency. There is no consensus regarding thiamine dosing when Wernicke encephalopathy is suspected. A longstanding dosing strategy for Wernicke encephalopathy is 100mg daily, yet updated clinical guidelines suggest using high-dose intravenous (HDIV) thiamine. OBJECTIVE: To describe thiamine prescribing practices at a large, public academic hospital and investigate clinical characteristics and outcomes associated with HDIV thiamine in patients with encephalopathy who received IV thiamine. METHODS: Electronic medical records of hospitalized patients who received thiamine between 4/4/2014 and 11/1/2015 were reviewed. Chi-square tests, Wilcoxon Rank Sum tests, and logistic regression were used to compare clinical variables in patients with encephalopathy who received HDIV thiamine (≥ 200mg twice daily) vs lower doses of IV thiamine. RESULTS: Among the total of 5236 thiamine orders, 29% (n = 1531) were IV; 10% (n = 150) of IV orders met HDIV criteria. In patients with encephalopathy who received IV thiamine (n = 432), HDIV thiamine was administered to 20% (n = 86) and only 2.1% (n = 9) received dosing consistent with Royal College of Physicians guidelines. In bivariable analyses, HDIV thiamine was associated with surgical services (p = 0.001), psychiatric consultation (p < 0.001), and decreased mortality (p = 0.004). In multivariable models, the association between HDIV thiamine and decreased in-hospital mortality did not meet statistical significance (p = 0.061). CONCLUSIONS: In a large, public academic hospital, guideline-concordant thiamine supplementation is rare and HDIV thiamine is infrequently prescribed to patients with encephalopathy. Further studies are needed to confirm the possible benefits of HDIV thiamine for patients with suspected thiamine-deficient encephalopathy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher

  3 / 2114 MEDLINE  
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[PMID]: 29386493
[Au] Autor:Nakamura T; Imai K; Hamanaka M; Yamazaki H; Yamada T; Mizuno T
[Ad] Address:Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital.
[Ti] Title:[A case of Wernicke encephalopathy with hypoacusia and MR high intensity of the inferior colliculi that normalized after thiamine administration].
[So] Source:Rinsho Shinkeigaku;58(2):100-104, 2018 Feb 28.
[Is] ISSN:1882-0654
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:A 61-year-old man was admitted to our institution with progressive hypoacusia, double vision, and lightheadedness. Neurological examination on day 6 of his illness showed severe hypoacusia, mild confusion, ocular motility disorder, truncal ataxia and absence of a deep tendon reflex. MRI fluid-attenuated inversion recovery imaging revealed symmetrical high intensities in the tectum of the midbrain, involving the bilateral inferior colliculi and the bilateral medial thalami, which suggested Wernicke encephalopathy (WE). Thiamine was administered immediately after completion of the MRI, and the patients' hearing and other abnormal neurologic signs improved rapidly within a few days, except for the absence of the deep tendon reflex. Whole blood examination at admission revealed very low levels of vitamin B1. The patient was discharged on day 19, and MRI on day 39 showed the disappearance of the abnormal high intensities involving the bilateral inferior colliculi. The present case indicates that hypoacusia and abnormal MRI signal due to WE might be normalized by administration of thiamine a few days after the onset of symptoms.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Process
[do] DOI:10.5692/clinicalneurol.cn-001082

  4 / 2114 MEDLINE  
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[PMID]: 29478423
[Au] Autor:Onishi H; Ishida M; Tanahashi I; Takahashi T; Ikebuchi K; Taji Y; Kato H; Akechi T
[Ad] Address:Department of Psycho-oncology,Saitama Medical University Saitama International Medical Center,Saitama,Japan.
[Ti] Title:Early detection and successful treatment of Wernicke's encephalopathy in outpatients without the complete classic triad of symptoms who attended a psycho-oncology clinic.
[So] Source:Palliat Support Care;:1-4, 2018 Feb 26.
[Is] ISSN:1478-9523
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Wernicke's encephalopathy (WE) is a neuropsychiatric disorder caused by a thiamine deficiency. Although WE has been recognized in cancer patients, it can be overlooked because many patients do not exhibit symptoms that are typical of WE, such as delirium, ataxia, or ocular palsy. Furthermore, outpatients with WE who intermittently present at psycho-oncology clinics have not been described as far as we can ascertain. METHOD: This report describes two patients who did not exhibit the complete classic triad of symptoms among a series with cancer and WE, and who attended a psycho-oncology outpatient clinic. Result Case 1, a 76-year-old woman with pancreatic cancer and liver metastasis, periodically attended a psycho-oncology outpatient clinic. She presented with delirium and ataxia as well as appetite loss that had persisted for 8 weeks. We suspected WE, which was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. Case 2, a 79-year-old man with advanced stomach cancer, was referred to a psycho-oncology outpatient clinic with depression that had persisted for about 1 month. He also had appetite loss that had persisted for several weeks. He became delirious during the first visit to the outpatient clinic. Our initial suspicion of WE was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. The key indicator of a diagnosis of WE in both patients was appetite loss. Significance of results This report emphasizes awareness of WE in the outpatient setting, even when patients do not exhibit the classical triad of WE. Appetite loss might be the key to a diagnosis of WE in the absence of other causes of delirium.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher
[do] DOI:10.1017/S1478951518000032

  5 / 2114 MEDLINE  
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[PMID]: 29468861
[Au] Autor:Swiatnicki W; Rajkow-Dedew J; Piotr Komunski P
[Ti] Title:Spine surgery under general anaesthesia complicated by Wernicke's encephalopathy in previously asymptomatic patient.
[So] Source:Bull Soc Sci Med Grand Duche Luxemb;1:61-7, 2016.
[Is] ISSN:0037-9247
[Cp] Country of publication:Luxembourg
[La] Language:eng
[Ab] Abstract:Wernicke's encephalopathy (WE) is a very rare complication of surgical intervention, especially among patients with no liver dysfunction and no history of alcohol abuse. In a surgical setting, Wernicke's syndrome was mostly associated with abdominal surgery (bariatric, e.g. gastric bypass, splenectomy) but there are no papers in the literature dealing with such a complication among spine patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:In-Process

  6 / 2114 MEDLINE  
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[PMID]: 28464962
[Au] Autor:Onishi H; Ishida M; Tanahashi I; Takahashi T; Taji Y; Ikebuchi K; Furuya D; Akechi T
[Ad] Address:Department of Psycho-Oncology,Saitama Medical University,Saitama International Medical Center,Saitama,Japan.
[Ti] Title:Wernicke encephalopathy without delirium in patients with cancer.
[So] Source:Palliat Support Care;16(1):118-121, 2018 Feb.
[Is] ISSN:1478-9523
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Wernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. Several reports of WE in cancer patients are known. WE is sometimes overlooked because most patients do not exhibit its typical symptoms (e.g., delirium, ataxia, ocular palsy). If delirium is not present, a diagnosis of WE is difficult because delirium is the hallmark symptom of WE. METHOD: Taken from a series on WE in cancer, we report two patients who developed WE without delirium during periodic psycho-oncology outpatient visits. RESULTS: Case 1. A 61-year-old woman with non-Hodgkin lymphoma who was periodically attending a psycho-oncology outpatient clinic developed an unsteady gait. WE was suspected because she also developed appetite loss for two weeks, and we could find no other laboratory findings to explain her unsteady gait. Our diagnosis was supported by abnormal serum thiamine and disappearance of the gait disturbance after intravenous thiamine administration. Case 2. A 50-year-old woman with breast carcinoma with bone metastasis developed an unsteady gait. WE was suspected because she also developed loss of appetite for two weeks, and no other laboratory findings could explain her unsteady gait. The diagnosis was supported by abnormal serum thiamine and disappearance of the gait disturbance after administration of intravenous thiamine. SIGNIFICANCE OF RESULTS: Our report emphasizes the importance of being aware of WE, even when patients do not present with delirium. The presence of loss of appetite for more than two weeks may be the key to a diagnosis of WE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1705
[Cu] Class update date: 180215
[Lr] Last revision date:180215
[St] Status:In-Data-Review
[do] DOI:10.1017/S1478951517000360

  7 / 2114 MEDLINE  
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[PMID]: 29400641
[Au] Autor:Diekfuss JA; De Larwelle J; McFadden SH
[Ad] Address:a The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati , OH.
[Ti] Title:Diagnosis makes a difference: Perceptions of older persons with dementia symptoms.
[So] Source:Exp Aging Res;44(2):148-161, 2018 Mar-Apr.
[Is] ISSN:1096-4657
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background/Study Context: Employing the stereotype content model and terror management theory, we examined whether stereotypes and feelings about persons with dementia vary depending on the type of dementia diagnosis and purported causes of the dementia. METHODS: Participants were randomly assigned to read one of four vignettes that depicted a man who consulted his doctor because of memory problems. All vignettes described the same symptoms and diagnostic tests, but each of four groups read a different result: all tests normal (Normal); Alzheimer's disease (AD); Wernicke-Korsakoff Syndrome (WKS) associated with alcohol abuse; and chronic traumatic encephalopathy (CTE) associated with head injuries from playing football in high school and college. Measures included a word fragment completion task, a stereotype content scale, and an emotions scale. RESULTS: Results showed no differences in the number of death-related words generated in the word fragment completion task and no differences in assessment of competence across the four groups. Those in the Normal, AD, and CTE groups evaluated the man as warmer than those in the WKS group. Participants in the AD condition showed more empathy than those in the WKS group. There were no differences in pity or fear but the CTE condition produced more envy and admiration and the WKS condition produced more contempt. CONCLUSION: These results suggest that different forms of dementia elicit varying emotional and cognitive responses.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[St] Status:In-Data-Review
[do] DOI:10.1080/0361073X.2017.1422475

  8 / 2114 MEDLINE  
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[PMID]: 29307105
[Au] Autor:Milone M; Velotti N; Musella M
[Ad] Address:Department of Advanced Biomedical Sciences, "Federico II" University, Via S. Pansini 5, 80131, Naples, Italy. milone.marco.md@gmail.com.
[Ti] Title:Wernicke Encephalopathy Following Laparoscopic Sleeve Gastrectomy-a Call to Evaluate Thiamine Deficiencies After Restrictive Bariatric Procedures.
[So] Source:Obes Surg;28(3):852-853, 2018 Mar.
[Is] ISSN:1708-0428
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1801
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[St] Status:In-Data-Review
[do] DOI:10.1007/s11695-017-3083-x

  9 / 2114 MEDLINE  
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[PMID]: 29385934
[Au] Autor:Dayangan Sayan C
[Ad] Address:a Departmant of Obstetrics and Gynecology , Kirikkale University Faculty of Medicine , Kirikkale , Turkey.
[Ti] Title:A case of prolonged hyperemesis resulting in hepatorenal failure, foetal distress and neonatal mortality.
[So] Source:J Obstet Gynaecol;:1-3, 2018 Jan 31.
[Is] ISSN:1364-6893
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Hyperemesis gravidarum is defined as a condition emerging during pregnancy, is prominent with severe nausea and vomiting, a water-electrolyte imbalance and liver-kidney function disorder and causes more than 5% loss of body weight. In cases of severe hyperemesis gravidarum, maternal morbidities such as water-electrolyte imbalance, hepatorenal failure, Wernicke's encephalopathy, splenic avulsion, oesophageal rupture, pneumothorax have been reported. We present a case of hyperemesis gravidarum, which continued until the third trimester and developed secondary hepatorenal failure, a water-electrolyte imbalance, intrauterine growth restriction, anhydramnios, foetal distress and neonatal mortality.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180201
[Lr] Last revision date:180201
[St] Status:Publisher
[do] DOI:10.1080/01443615.2017.1378874

  10 / 2114 MEDLINE  
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[PMID]: 29308003
[Au] Autor:Xie B; Si ZZ; Tang WT; Qi HZ; Li T
[Ad] Address:Organ Transplantation Center, The Second Xiang-ya Hospital, Central South University, Changsha 410011, Hunan Province, China.
[Ti] Title:Wernicke encephalopathy in a patient after liver transplantation: A case report.
[So] Source:World J Gastroenterol;23(47):8432-8436, 2017 Dec 21.
[Is] ISSN:2219-2840
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported after liver transplantation. Here, we report a case of a 45-year-old nonalcoholic male patient who developed psychiatric and neurological disturbance 15 d after receiving orthotopic liver transplantation because of hepatitis B-related cirrhosis and portal hypertension. Brain magnetic resonance imaging (MRI) showed symmetric high-signal intensities in the periaqueductal area. The patient was diagnosed with WE and given intravenous high-dose vitamin B1 immediately. His neurological disturbance resolved in 7 d after receiving the vitamin B1. Brain MRI after 5 mo showed nearly complete recovery. Most WE cases may be misdiagnosed in patients after liver transplantation, and we should pay more attention to its onset.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180110
[Lr] Last revision date:180110
[St] Status:In-Process
[do] DOI:10.3748/wjg.v23.i47.8432


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