Severe Medical Complications Research Articles

Photosynthesis-Inspired NIR-Triggered Fe₃O₄@MoS₂ Core-Shell Nanozyme for Promoting MRSA-Infected Diabetic Wound Healing.

Bacterial infections can lead to severe medical complications, including major medical incidents and even death, posing a significant challenge in clinical trauma repair. Consequently, the development of new, efficient, and non-resistant antimicrobial agents has become a priority for medical practitioners. In this study, a stepwise hydrothermal reaction strategy is utilized to prepare Fe3O4@MoS2 core-shell nanoparticles (NPs) with photosynthesis-like activity for the treatment of bacterial infections. The Fe3O4@MoS2 NPs continuously catalyze the production of reactive oxygen species (ROS) from hydrogen peroxide through photosynthesis-like reactions and convert light energy into heat with a photothermal efficiency of 30.30%. In addition, the photosynthetically generated ROS, combined with the iron-induced cell death mechanism of the Fe3O4@MoS2 NPs, confer them with exceptional and broad-spectrum antibacterial properties, achieving antimicrobial activities of up to 98.62% for Staphylococcus aureus, 99.22% for Escherichia coli, and 98.55% for methicillin-resistant Staphylococcus aureus. The composite exhibits good cell safety and hemocompatibility. Finally, a full-thickness diabetic wound model validates the significant pro-healing properties of Fe3O4@MoS2 in chronic diabetic wounds. Overall, the design of photosynthesis-inspired Fe3O4@MoS2 presents new perspectives for developing efficient photothermal nano-enzymatic compounds, offering a promising solution to the challenges of antimicrobial drug resistance and antibiotic misuse.

A guide to the community management of paediatric eating disorders.

Eating disorders (EDs) are a group of serious, potentially life-threatening illnesses that typically have their onset during adolescence and can be associated with severe medical and psychosocial complications. The impact of EDs on caregivers and other family members can also be significant. Health care providers (HCPs) play an important role in the screening and management of adolescents and young adults with EDs. This position statement assists community-based HCPs with recognizing, diagnosing, and treating EDs in the paediatric population. Screening modalities, indications for hospitalization, medical complications, and monitoring of young people with EDs are summarized. Current evidence supports the use of family-based treatment (FBT) as the first-line psychological therapeutic modality for adolescents with restrictive EDs. While the provision of FBT may be beyond the scope of practice for some community physicians, this statement reviews its core tenets. When an ED is diagnosed, early application of these principles in the community setting by HCPs may slow disease progression and provide guidance to families.

Neurocognitive and psychiatric outcomes associated with postacute COVID-19 infection without severe medical complication: a meta-analysis

BackgroundCognitive symptoms are often reported by those with a history of COVID-19 infection. No comprehensive meta-analysis of neurocognitive outcomes related to COVID-19 exists despite the influx of studies after the...

European Achondroplasia Forum Practical Considerations for Following Adults with Achondroplasia.

Achondroplasia is a lifelong condition requiring lifelong management. There is consensus that infants and children with achondroplasia should be managed by a multidisciplinary team experienced in the condition. However, many people are lost to follow-up after the transition from paediatric to adult care, and there is no standardised approach for management in adults, despite the recent availability of international consensus guidelines. To address this, the European Achondroplasia Forum has developed a patient-held checklist to support adults with achondroplasia in managing their health. The checklist highlights key symptoms of spinal stenosis and obstructive sleep apnoea, both among the most frequent and potentially severe medical complications in adults with achondroplasia. The checklist acts as a framework to support individuals and their primary care provider in completing a routine review. General advice on issues such as blood pressure, pain, hearing, weight, adaptive aids, and psychosocial aspects are also included. The checklist provides key symptoms to be aware of, in addition to action points so that people can approach their primary care provider and be directed to the appropriate specialist, if needed. Additionally, the European Achondroplasia Forum offers some ideas on implementing the checklist during the transition from paediatric to adult care, thus ensuring the existing multidisciplinary team model in place during childhood can support in engaging individuals and empowering them to take responsibility for their own care as they move into adulthood.

Performance evaluation of off-grid solar systems for critical medical instruments in remote regions

In areas with limited access to electricity or during power outages, ensuring continuous and reliable use of grid-powered electrical instruments is challenging, especially in remote emergency centers. A stable source of electricity is crucial to prevent disruptions in power supply, as they can lead to severe medical complications, jeopardize patient well-being, and even result in fatal incidents. To address this issue, integrating renewable electricity sources such as off-grid solar systems into existing power supply infrastructure can be a viable solution. Recent studies suggest that off-grid solar systems can be reliable and sustainable options for powering medical facilities, particularly in areas lacking uninterrupted grid connectivity. Therefore, this research aims to evaluate the feasibility, benefits, and challenges of integrating off-grid power to support critical medical instruments. Based on an extensive literature review, interviews with experts, and surveys among relevant users, this study finds that the system has the capability to maintain a consistent, dependable power supply, even during adverse weather conditions. Cost and feasibility are highlighted as paramount considerations, based on surveys and focus group results. The study concludes that off-grid solar systems offer an economical, low-maintenance, and environmentally sustainable alternative for remote medical facilities. Finally, this study proposes recommendations to optimize critical device performance during power outages and improve overall system functionality and efficiency.

Factors influencing decision-making for the anesthetic technique in molar pregnancy patients for suction curettage: A retrospective study

Anesthetic techniques for suction curettage in molar pregnancy patients described in the literature can be classed into general anesthesia and regional anesthesia techniques. The aim of the present study was to report the factors influencing the decision-making for the choice of anesthetic technique in molar pregnancy patients who underwent suction curettage at Siriraj Hospital. The reported intraoperative and postoperative complications were also analyzed.A retrospective chart review was conducted among pregnant women diagnosed with molar pregnancy who had underwent suction curettage under anesthesia at Siriraj Hospital between January 2007 to September 2021. Overall, 244 patients were diagnosed with molar pregnancy, with 110 of these included for analysis in this study after consideration of the inclusion and exclusion criteria. Quantitative data of the included patients were analyzed by either unpaired t-test or Mann–Whitney U test, while qualitative data were analyzed by the chi-square test. Logistic regression was used to establish the factors influencing the decision-making for the anesthetic technique.General anesthesia was the most preferred anesthetic technique (77.4%) in the molar pregnancy patients who had underwent suction curettage, followed by regional anesthesia (11.3%) and intravenous sedation (11.3%). General anesthesia was likely to be used in patients with an enlarged uterine size ≥ 16 weeks with an adjusted odds ratio of 11.64 (95% CI 1.08–125.72, p < 0.05). Patients with a larger uterine size were associated with higher beta-hCG levels, resulting in more severe medical complications, such as hyperthyroidism and hyperemesis gravidarum (p < 0.05). Intraoperative complications, such as uterine atony (17.7%), massive hemorrhage (7.3%), and pulmonary edema (4.2%), were confined within patients receiving general anesthesia, but there was no statistical significance. None of the patients had anesthesia-related complications. The reported postoperative serious complications, such as pulmonary edema (4.2%), which required postoperative intubation and transferal to the intensive care unit, were all in the general anesthesia group. Patients with higher co-morbidities were advised by anesthesiologists to receive general anesthesia. However, an enlarged uterine size ≥ 16 weeks was the only factor that had an influence on the decisions of the anesthesiologists to provide general anesthesia.

Evaluation of severe adverse cutaneous drug reactions in patients admitted to tertiary care center: A cross-sectional study.

Adverse cutaneous drug reactions (ACDRs) are common and potentially life-threatening, while also hindering patient compliance to medications. Given the regional differences in patterns and prevalence of ACDRs, it is important to study the epidemiology, as well as the clinical and outcome patterns of patients with ACDRs in Iran. This cross-sectional study on ACDRs was conducted among hospitalized patients in a referral university hospital in the city of Isfahan, Iran. The patients' demographics, clinical information, and outcomes, including age, gender, past medical history, medication history, drug reaction with eosinophilia and systemic symptoms (DRESS) diagnosis, Steven-Johnson Syndrome (SJS) diagnosis, toxic epidermal necrosis (TEN) diagnosis, treatment regimen (steroids or intravenous immunoglobulin [IVIG]) and outcome information, including intensive care requirements, severe medical complications, or death, were obtained from medical records. A total of 195 patients with a mean age of 40 years and consisting of 61% females were included. Carbamazepine, lamotrigine, sodium valproate, and phenytoin are the most commonly reported medications. Rate of complications was 45% with DRESS, SJS, and TEN diagnosed in 26%, 47%, and 19%, respectively. Treatment was carried out with steroids and IVIG in 81% and 19%, respectively. Among patients, 15% required intensive care and 5% died. Diagnosis of TEN, older age, and baseline heart disease were predictors of mortality. Patients with SJS were younger and more likely to be males, and they were more likely to have eye complications. On the other hand, patients with the diagnosis of TEN were more likely to receive IVIG and intensive care, and had a higher mortality rate. Our study provides insight into the demographics and clinical patterns of Iranian patients with ACDRs. This will help in predicting rates of complications, treatments, and outcomes in patients and therefore make proper management decisions.

Dexamethasone in Post-spinal Surgery Recovery: A Saudi Arabian Cross-sectional Study on Complication Reduction in Adults

Abstract Introduction: Spinal surgery, crucial for addressing deformities, fractures, tumours and degenerative diseases, is associated with significant risks such as persistent pain, infections and severe medical complications. These risks often lead to extended hospitalisation and long-term morbidities, underscoring the need for effective post-operative care. The role of glucocorticosteroids, particularly dexamethasone, has been a focus due to its anti-inflammatory effects and benefits in pain reduction and wound healing. However, the specific impact of dexamethasone on spinal surgery outcomes, especially within the Saudi Arabian population, remains underexplored. This study aims to address this gap by investigating the effects of dexamethasone on post-spinal surgery outcomes in this demographic. Methods: This cross-sectional study was conducted in Saudi Arabia, targeting adults who had undergone spinal surgery. Data collection occurred between 18 August and 26 August 2023. A total of 833 participants were selected through stratified random sampling based on a prevalence of 5%, a confidence level of 95% and a margin of error of 5%. The study included adults aged 18 and older from Saudi Arabia who received dexamethasone post-spine surgery, with no specific exclusion criteria. Data were collected using a structured, expert-validated questionnaire with 27 items, focusing on demographic details and questions about dexamethasone’s role in spinal surgery. Results: The study enrolled 833 participants, primarily in the 25–34 age bracket, with a majority being male and holding Bachelor’s degrees. Most participants rated their overall experience with spinal surgery as ‘Excellent’ and reported varied hospital stay durations, with many staying for 3–5 days. A significant majority received dexamethasone as part of their treatment, and amongst them, a substantial proportion experienced post-operative complications. Notably, 74.8% of participants who received dexamethasone rated the effectiveness of pain management during their recovery as ‘Excellent’. The study found a significant association between dexamethasone administration and improved post-operative outcomes, including fewer complications, shorter hospital stays and better pain management. Conclusion: This study contributes significantly to the literature by demonstrating that dexamethasone administration can reduce post-operative complications, shorten hospital stays and enhance pain management in spinal surgery patients within the Saudi Arabian population. These findings align with previous research and offer new insights into a previously underexplored demographic. The implications for clinical practice and public health are considerable, suggesting a re-evaluation of post-operative care protocols. The study’s findings serve as a call to action for integrating these insights into clinical guidelines and highlight the need for further research to explore dexamethasone’s long-term effects and applicability across diverse populations.

Fighting flu: novel CD8+ T-cell targets are required for future influenza vaccines.

Seasonal influenza viruses continue to cause severe medical and financial complications annually. Although there are many licenced influenza vaccines, there are billions of cases of influenza infection every year, resulting in the death of over half a million individuals. Furthermore, these figures can rise in the event of a pandemic, as seen throughout history, like the 1918 Spanish influenza pandemic (50 million deaths) and the 1968 Hong Kong influenza pandemic (~4 million deaths). In this review, we have summarised many of the currently licenced influenza vaccines available across the world and current vaccines in clinical trials. We then briefly discuss the important role of CD8+ T cells during influenza infection and why future influenza vaccines should consider targeting CD8+ T cells. Finally, we assess the current landscape of known immunogenic CD8+ T-cell epitopes and highlight the knowledge gaps required to be filled for the design of rational future influenza vaccines that incorporate CD8+ T cells.

Severe-Enduring Anorexia Nervosa (SE-AN): a case series

BackgroundAnorexia Nervosa (AN) poses significant therapeutic challenges, especially in cases meeting the criteria for Severe and Enduring Anorexia Nervosa (SE-AN). This subset of AN is associated with severe medical complications, frequent use of services, and the highest mortality rate among psychiatric disorders.Case presentationIn the present case series, 14 patients were selected from those currently or previously taken care of at the Eating Disorders Outpatients Unit of the Maggiore Hospital in Bologna between January 2012 and May 2023. This case series focuses on the effects of the disease, the treatment compliance, and the description of those variables that could help understand the great complexity of the disorder.ConclusionThis case series highlights the relevant issue of resistance to treatment, as well as medical and psychological complications that mark the life course of SE-AN patients. The chronicity of these disorders is determined by the overlapping of the disorder's ego-syntonic nature, the health system's difficulty in recognizing the problem in its early stages, and the presence of occupational and social impairment.

From squid giant axon to automated patch-clamp: electrophysiology in venom and antivenom research.

Ion channels play a crucial role in diverse physiological processes, including neurotransmission and muscle contraction. Venomous creatures exploit the vital function of ion channels by producing toxins in their venoms that specifically target these ion channels to facilitate prey capture upon a bite or a sting. Envenoming can therefore lead to ion channel dysregulation, which for humans can result in severe medical complications that often necessitate interventions such as antivenom administration. Conversely, the discovery of highly potent and selective venom toxins with the capability of distinguishing between different isoforms and subtypes of ion channels has led to the development of beneficial therapeutics that are now in the clinic. This review encompasses the historical evolution of electrophysiology methodologies, highlighting their contributions to venom and antivenom research, including venom-based drug discovery and evaluation of antivenom efficacy. By discussing the applications and advancements in patch-clamp techniques, this review underscores the profound impact of electrophysiology in unravelling the intricate interplay between ion channels and venom toxins, ultimately leading to the development of drugs for envenoming and ion channel-related pathologies.

Eating Disorders in Youth with Chronic Health Conditions: Clinical Strategies for Early Recognition and Prevention.

Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions. In this review, clinical strategies are provided to support youth with chronic health conditions through early recognition of eating disorder behaviors and prompt referral to treatment, which is important for a better prognosis. Suggestions are also given to mitigate their risk of developing eating disorders by proactively addressing risk factors and offering thoughtful anticipatory guidance that promotes a positive relationship with food and eating.

BARNASE-BARSTAR SPECIFIC INTERACTION REGULATES CAR-T CELLS CYTOTOXIC ACTIVITY TOWARD MALIGNANCY

The development of CAR-T specific therapy made a revolution in modern oncology. Despite the pronounced therapeutic effects, this novel approach displayed several crucial limitations caused by the complications in pharmacokinetics and pharmacodynamics controls. The presence of the several severe medical complications of CAR-T therapy initiated a set of attempts aimed to regulate their activity in vivo. We propose to apply the barnase-barstar system to control the cytotoxic antitumor activity of CAR-T cells. To menage the regulation targeting effect of the system we propose to use barstar-modified CAR -T cells together with barnase-based molecules. Barnase was fused with designed ankyrin repeat proteins (DARPins) specific to tumor antigens HER2 (human epidermal growth factor receptor 2) The application of the system demonstrates the pronounced regulatory effects of CAR-T targeting.

A photoactive self-healing carboxymethyl chitosan-based hydrogel for accelerated infected wound healing through simultaneously modulating multiple critical tissue repair factors

Infected wounds cause severe medical complications and even chronic mortality, leading to persistent health burdens. Therefore, the enhancement of wound healing has been a major goal of medical researchers. Herein, a photoactive self-healing hydrogel (termed as Macropatch), composed of carboxymethyl chitosan (CMCS), tannic acid (TA) and graphitic carbon nitride g-C3N4 (GCN), was developed to promote wound healing through simultaneously modulating pathological related factors. We identified that dynamic hydrogen bond, hydrophobic interaction and crosslinking between hydrogel backbones endowed Macropatch with good self-healing capability and mechanical property, allowing for protecting the wound from further injury. In addition, Macropatch exhibited superior tissue adhesiveness and cell affinity due to numerous catechol groups of TA chains, and enabled tight wound adhesion to seal organ bleeding. Specifically, GCN endowed Macropatch with improving mechanical strength, self-healing ability and especially visible light-induced antibacterial activity, leading to a fast recovery of bacteria-infected wounds. More remarkably, benefiting from inherent and photodynamic antibacterial properties, Macropatch could prevent bacterial infections under visible light irradiation, and consequently increase the collagen synthesis and re-epithelization, accelerating bacteria-infected wound healing process. Overall, photoactive Macropatch is a safe wound dressing with the potential of overcoming challenges in infectious wound healing, and might be applied in clinical condition.

Abstract 3678: Rewiring of amino acid metabolism in neurofibromatosis type 1-related tumors

Abstract Neurofibromatosis type 1 (NF1) is a tumor-predisposing genetic disorder caused by heterozygous mutations in the NF1 gene encoding for the tumor suppressor Neurofibromin. Biallelic NF1 inactivation in Schwann cells leads to the onset of neurofibromas, benign neoplasms that can cause severe medical complications and give rise to malignant peripheral nerve sheath tumors (MPNSTs), for which no treatment exists. Neurofibroma cells undergo bioenergetic changes required to sustain their malignant transformation. Our group has shown that inhibition of the mitochondrial chaperone TRAP1, a master metabolic regulator, hampers MPNST cell tumorigenicity. A growing number of evidence indicates that urea cycle (UC) dysregulation can redirect metabolic substrates to specific biosynthetic routes in many tumor cell types. We have found that a complete UC is absent in MPNST cell models, as they lack ornithine transcarbamylase (OTC), a key UC enzyme that converts ornithine into citrulline. In the absence of TRAP1, MPNST cells strongly reduce arginine levels and accumulate ornithine through the activity of the mitochondrial enzymes arginase 2 (ARG2) and ornithine aminotransferase (OAT). These changes can reverberate on glutamine and proline levels ultimately affecting extracellular matrix deposition, motility and ROS homeostasis, as well as on ornithine-dependent polyamine biosynthesis that can regulate cell growth and proliferation. Surprisingly, in the absence of TRAP1 MPNST cells also accumulate citrulline, even though they do not express either OTC or any nitric oxide synthase (NOS) isoform that converts arginine into citrulline. We ascribe citrulline production to the activity of dimethylarginine dimethylaminohydrolase (DDAH) enzymes, involved in the catabolism of asymmetric dimethylarginines. Induction of DDAHs indicates an elevated protein catabolism that could contribute to tune MPNST cell tumorigenicity. A thorough comprehension of the amino acid metabolism rewiring in NF1-related tumors may unveil new targetable liabilities of cancer cells to be exploited for the design of new effective therapeutic approaches. Citation Format: Martina La Spina. Rewiring of amino acid metabolism in neurofibromatosis type 1-related tumors. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3678.

“Fighting for the Last Gasp”—Severe Borderline Personality Disorder and Posttraumatic Stress Disorder, Chronic Deliberate Ingestion of Foreign Bodies, and Palliative Struggles in Intensive Care

Repeated deliberate ingestion of foreign bodies can have tragic long-term consequences. We report the case of a young woman with borderline personality disorder and chronic posttraumatic stress disorder, whose chronic repeated ingestion of razor blades and batteries eventually resulted in severe medical complications. We focus on the involvement of the consultation-liaison psychiatry team as part of her multidisciplinary care, predominantly in the intensive care environment. Her care posed extensive challenges due to the retraumatizing effects of the intensive care environment and the measures required to provide life-sustaining care when the young woman was emotionally dysregulated. Strategies used to address team dynamics and "compassion fatigue" are discussed, including some pertinent relevant literature that was used as educational material for staff to develop a better understanding of the confronting and apparently self-defeating antitherapeutic behavior she frequently displayed. The consultation-liaison psychiatry team has a significant role to play in such situations, carefully balancing patient advocacy roles while simultaneously supporting staff who may be vicariously traumatized by the substantial emotional challenges of providing care in these circumstances.

Geraniin targeting CaMKK2 inhibits lipid accumulation in 3T3-L1 adipocytes by suppressing lipogenesis

Obesity has become a worldwide burden and is associated with severe medical complications. Geraniin is a polyphenolic compound that has a wide range of bioactive properties. There is also evidence to support its pharmacological effects on improving lipid accumulation and obesity. This research investigates the effect of geraniin on lipid accumulation in adipocytes and the underlying mechanism. Mature adipocytes were differentiated from immature 3T3-L1 cells. Oil Red O staining and a triglyceride content determination were conducted to evaluate the intracellular lipid accumulation. Molecular docking studies were performed to determine the interaction between geraniin and the key proteins. Western blotting was used to detect the expression of lipogenic enzymes and transcription factors. Geraniin dose-dependently inhibited lipid accumulation in adipocytes by reducing the expression of fatty acid synthase and increasing the phosphorylation level of acetyl-coenzyme A carboxylase. Moreover, geraniin promoted the phosphorylation of AMP-activated protein kinase (AMPK) and further reduced the expression of lipogenic transcription factors (peroxisome proliferator-activated receptor gamma and CCAAT/enhancer binding protein alpha). The expression of the calcium/calmodulin-dependent protein kinase kinase 2 (CaMKK2) was increased by the geraniin administration. The molecular docking study demonstrated that geraniin can interact with CaMKK2, which is an upstream kinase of AMPK. A selective CaMKK2 inhibitor reversed the suppressive effect of geraniin on lipogenesis. Geraniin targeted CaMKK2 to inhibit lipid accumulation in 3T3-L1 adipocytes by suppressing lipogenesis, and this supports its potential as a candidate natural anti-obesity drug.

Barnase-barstar Specific Interaction Regulates Car-T Cells Cytotoxic Activity toward Malignancy

The development of CAR-T specific therapy made a revolution in modern oncology. Despite the pronounced therapeutic effects, this novel approach displayed several crucial limitations caused by the complications in pharmacokinetics and pharmacodynamics controls. The presence of the several severe medical complications of CAR-T therapy initiated a set of attempts aimed to regulate their activity in vivo. We propose to apply the barnase-barstar system to control the cytotoxic antitumor activity of CAR-T cells. To menage the regulation targeting effect of the system we propose to use barstar-modified CAR-T cells together with barnase-based molecules. Barnase was fused with designed ankyrin repeat proteins (DARPins) specific to tumor antigens HER2 (human epidermal growth factor receptor 2) The application of the system demonstrates the pronounced regulatory effects of CAR-T targeting.

A Novel Lightweight CNN Architecture for the Diagnosis of Brain Tumors Using MR Images.

Over the last few years, brain tumor-related clinical cases have increased substantially, particularly in adults, due to environmental and genetic factors. If they are unidentified in the early stages, there is a risk of severe medical complications, including death. So, early diagnosis of brain tumors plays a vital role in treatment planning and improving a patient's condition. There are different forms, properties, and treatments of brain tumors. Among them, manual identification and classification of brain tumors are complex, time-demanding, and sensitive to error. Based on these observations, we developed an automated methodology for detecting and classifying brain tumors using the magnetic resonance (MR) imaging modality. The proposed work includes three phases: pre-processing, classification, and segmentation. In the pre-processing, we started with the skull-stripping process through morphological and thresholding operations to eliminate non-brain matters such as skin, muscle, fat, and eyeballs. Then we employed image data augmentation to improve the model accuracy by minimizing the overfitting. Later in the classification phase, we developed a novel lightweight convolutional neural network (lightweight CNN) model to extract features from skull-free augmented brain MR images and then classify them as normal and abnormal. Finally, we obtained infected tumor regions from the brain MR images in the segmentation phase using a fast-linking modified spiking cortical model (FL-MSCM). Based on this sequence of operations, our framework achieved 99.58% classification accuracy and 95.7% of dice similarity coefficient (DSC). The experimental results illustrate the efficiency of the proposed framework and its appreciable performance compared to the existing techniques.

Updates in the Assessment and Management of Agitation.

Agitated patients can be dangerous to themselves and others. In fact, severe medical complications and death can occur with severe agitation. Because of this, agitation is considered a medical and psychiatric emergency. Regardless of the treatment setting, identifying the agitated patient early is a necessary skill. The authors review relevant literature regarding the identification and management of agitation and summarize current recommendations for adults, as well as children and adolescents.