Psychosomatics
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Medical-surgical rehospitalizations within a month after discharge among patients with diabetes result in tremendous costs to the US health care system. ⋯ Co-morbid serious mental illness in patients with diabetes is independently associated with greater risk of early medical-surgical rehospitalization. Future research is needed to define and specify targets for interventions at points of care transition for this vulnerable patient population.
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Although anesthetics have been used for more than a century, their mechanisms of action remain poorly understood. Given that a number of intraoperative and postoperative neuropsychiatric syndromes have been linked to the use of anesthetics, practitioners should familiarize themselves with these conditions. ⋯ Emergence delirium, postoperative delirium, postoperative cognitive dysfunction, and intraoperative awareness can develop in association with use of inhalation anesthetics and intravenously administered anesthetics.
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Observational Study
The impact of soluble interleukin-2 receptor as a biomarker of delirium.
Biomarkers might help to predict the emergence of delirium. Advance warning of the threats of this condition could potentially reduce significant morbidity, mortality, and costs of hospitalizing patients. ⋯ High levels of sIL-2R appear to be a useful biomarker to identify patients with high risk for a delirious state.
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Quality of health care services can be improved by promoting patient- and family-centered care informed by patient and family satisfaction with services delivered. Few studies have been conducted looking at satisfaction with psychiatric consultation services within an inpatient pediatric hospital setting. ⋯ This quality improvement project underscores the importance of having psychiatry consultants convey their clinical impressions and recommendations, communicate effectively, and provide helpful interventions to parents and young adults in the pediatric hospital. It serves as an initial step responding to national consumers' demand for higher levels of quality and service and will provide guidance in future design and implementation of more comprehensive quality improvement projects.