Category Archives: Medical Article Review

The Epidemiology of Delirium: A Paper from 2013

Delirium

There is an interesting paper on Delirium from 2013 by Davis et al titled ‘The Epidemiology of Delirium: Challenges and Opportunities for Population Studies’. In the first section of the paper the authors look at the problems faced in epidemiological research. The issues here are particularly relevant to epidemiological researchers but also hold some interest in the interpretation of epidemiological studies or meta-analyses/systematic reviews. A key point in the discussion looked at how results were interpreted – were subjects with complete data included only (with associated bias) or was there an attempt to anticipate data for missing subjects (e.g using random effects modelling).

What I found quite interesting about the paper is the later section which reviews some of the epidemiological studies. The Gerontological Database research study revealed some very useful data about prevalence in people over the age of 85. Age was strongly linked to the prevalence of Delirium in this study which used DSM-IV criteria. The prevalence of Delirium in the 85-89 year age group was 19% compared to 39% in the 95+ age group. The only drawback was that the confidence interval data was missing and it wasn’t clear if this was point or 1-month period prevalence as reported for other data from the study. Regardless, the original study would merit further attention as if this pattern is replicated there is likely to be an important biological link (e.g blood-brain barrier integrity etc) that could be further investigated. The other point is whether there is comorbid Dementia. Nevertheless this does not escape the fact that there is Delirium regardless of whether it is a comorbidity.

The final section looks at the issue of improving epidemiological studies and the methodology here has some overlap with approaches with the potential to improve clinical practice.

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog. Conflicts of Interest: For potential conflicts of interest please see the About section.

The Origins of Catatonia

KahlbaumThe German psychiatrist Karl Ludwig Kahlbaum first described Catatonia in a lecture in 1868 according to this paper. Kahlbaum later wrote up his description of Catatonia in 1874 in ‘Die Katatonie oder das Spannungsirresein. Eine klinische Form psychischer Krankheit’. Interested readers can find a copy of this book in various formats at the Internet Archive in the ‘Medical Heritage Library’.

While Kahlbaum recognised Catatonia in association with many psychiatric and medical illnesses, it was Kraeplin who later took Catatonia and subsumed it under Dementia Praecox which later became Schizophrenia. The rest is history.

However there are many papers in the research literature that show Catatonia in association with medical as well as mental illnesses. Just as Kahlbaum originally reported.

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog. Conflicts of Interest: For potential conflicts of interest please see the About section.

 

 

Brodmann Area 51 – The Prepiriform Area

Korbinian_Brodmann

Dr Korbinian Brodmann, German Neurologist, Frontpiece of ‘Localisation in the Cerebral Cortex’, 1909, Public Domain*

In the nineteenth century the eminent German Neurologist Dr Korbinian Brodmann developed a brain map based on the brain’s microscopic properties. This map has been very successful and is used even today. Many of the Brodmann areas have been covered in detail elsewhere on this site (see Appendix). This post continues the series looking at selective Brodmann areas in this instance focusing on Brodmann Area 51. Brodmann does not describe this area in humans. Instead, in his classic 1909 text ‘Localisation in the Cerebral Cortex’ he provides a comparison of neuroanatomy in several distinct species. Brodmann Area 51 is described in the Kinkajou. The Kinkajou which can be seen in this video is an arboreal mammal living in Central and South America. Brodmann Area 51 is referred to by Brodmann as the Prepiriform area within the Olfactory region. Brodmann also describes this area in the Rabbit and Ground Squirrel. Brodmann also describes Brodmann Area 51 in the Hedgehog noting that it is expanded and he further subdivides this into 51a, 51b, 51c and 51d. This perhaps reflects the different significance of the Olfactory apparatus across species.

Appendix

Neuroanatomy Resources

*Public Domain in those countries where the Copyright term of the life of the author (Korbinian Brodmann 1868-1918) plus the additional country specific term has lapsed from Copyright at the time of writing

An index of the site can be found here. The page contains links to all of the articles in the blog in chronological order. Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.