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Pomalidomide, sold under the brand names Pomalyst and Imnovid, [7] [8] is an anti-cancer medication used for the treatment of multiple myeloma and AIDS-related Kaposi sarcoma. [ 7 ] Pomalidomide was approved for medical use in the United States in February 2013, [ 10 ] and in the European Union in August 2013. [ 8 ]
The thalidomide molecule is a synthetic derivative of glutamic acid and consists of a glutarimide ring and a phthaloyl ring (Figure 5). [15] [16] Its IUPAC name is 2-(2,6-dioxopiperidin-3-yl)isoindole-1,3-dione and it has one chiral center [15] After thalidomide's selective inhibition of TNF-α had been reported, a renewed effort was put in thalidomide's clinical development.
The Confusion Assessment Method (CAM) is a diagnostic tool developed to allow physicians and nurses to identify delirium in the healthcare setting. [1] It was designed to be brief (less than 5 minutes to perform) and based on criteria from the third edition-revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) .
The systems of the body most affected by chemotherapy drugs include visual and semantic memory, attention and motor coordination and executive functioning. [9] [10] These effects can impair a chemotherapy patient's ability to understand and make decisions regarding treatment, perform in school or employment and can reduce quality of life. [10]
An early warning system (EWS), sometimes called a between-the-flags or track-and-trigger chart, is a clinical tool used in healthcare to anticipate patient deterioration by measuring the cumulative variation in observations, most often being patient vital signs and level of consciousness. [1]
The following questions are put to the patient. Each question correctly answered scores one point. A score of 7–8 or less suggests cognitive impairment at the time of testing, [4] although further and more formal tests are necessary to confirm a diagnosis of dementia, delirium or other causes of cognitive impairment.
The second theory postulates that organic compounds are increased in uremia to protect the brain and result in injury by, like in the first theory, reverse osmosis. [1] More recent studies on rats noted that brain concentrations of organic osmolytes were not increased relative to baseline after rapid dialysis.
Postoperative cognitive dysfunction (POCD) is a decline in cognitive function (especially in memory and executive functions) that may last from 1–12 months after surgery, or longer. [1] In some cases, this disorder may persist for several years after major surgery. [2] POCD is distinct from emergence delirium. Its causes are under ...