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Surgery cognitive

Barbara Deschler, Gabriele Ihorst, Michael Hüll, Peter Baier
AIMS: The effectiveness of surgery depends on it being carried out safely, which allows patients to return to independent lives. Because gastrointestinal cancers are a major cause of morbidity and mortality in older people, we examined the dynamics of recuperation after elective, curative surgery. As disease parameters alone may not suffice to address geriatric patients' issues after onco-surgical interventions, Comprehensive Geriatric and QOL Assessments (CGA/QOL) were performed at four time points to gain information on clinical, functional, and cognitive aspects...
October 9, 2018: Journal of Geriatric Oncology
Lei Chen, Liangrong Wang, Qian Zhuo, Qiong Zhang, Feifei Chen, Liling Li, Lina Lin
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a common complication after cardiac surgery that influences the clinical outcomes and quality of life of patients. This study aimed to evaluate the effects of Shenmai injection (SMI) on POCD of patients who underwent cardiac valve replacement under cardiopulmonary bypass (CPB). METHODS: This prospective, randomized, controlled trial was conducted from September 2014 to January 2017. Eighty-eight patients receiving cardiac valve replacement under CPB were randomized into the control (C) or the SMI (S) group...
October 11, 2018: BMC Anesthesiology
Asri Maharani, Piers Dawes, James Nazroo, Gindo Tampubolon, Neil Pendleton
BACKGROUND: Visual impairment has been associated with lower cognitive ability among older adults, yet little is known about whether improving visual function with cataract surgery would be associated with slower cognitive decline. This study aimed to assess whether trajectories of cognitive decline differed before and after cataract surgery and compare those trajectories between older adults with cataract surgery and without cataract. METHODS AND FINDINGS: Data were drawn from the English Longitudinal Study of Ageing (ELSA) Wave 1 (2002/03) until Wave 7 (2014/15)...
2018: PloS One
Mark A Oldham, Jacqueline Vachon, David Yuh, Hochang B Lee
OBJECTIVES: To summarize evidence on cognitive outcomes after heart valve surgery; secondary aim, to examine whether aortic and mitral valve surgery are associated with different cognitive outcomes. DESIGN: Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review and meta-analysis. SETTING: Cardiac surgery. PARTICIPANTS: Individuals undergoing heart valve surgery. MEASUREMENTS: We searched MEDLINE, EMBASE, and PsycINFO for peer-reviewed reports of individuals undergoing heart valve surgery who underwent pre- and postoperative cognitive assessment...
October 11, 2018: Journal of the American Geriatrics Society
Bei Wang, Shengjin Ge, Wanxia Xiong, Zhanggang Xue
BACKGROUND: Postoperative cognitive dysfunction (POCD) seriously reduces quality of life and is associated with increased morbidity and mortality. The causes and neuropathogenesis of POCD remain largely unknown. Resveratrol, a sirtuin 1 (Sirt1) activator, is a polyphenol compound found in red wine that has protective functions in neuropathology paradigms. Endoplasmic reticulum stress (ERS) is a primary cellular response that activates the unfolded protein response (UPR). ERS and UPR mediate molecular and biochemical mechanisms related to neurodegeneration; however, the roles of ERS and Sirt1 in POCD remain unclear...
October 10, 2018: BMC Anesthesiology
Sonia Jiménez-Mola, César Calvo-Lobo, Javier Idoate-Gil, Jesús Seco-Calvo
BACKGROUND: Hip fractures may be the greatest complication secondary to osteoporotic disorder. The objective of this study was to determine the influence of age distribution in the functionality, comorbidity, complications and surgical features of older adults with hip fractures. METHODS: A prospective cohort study was carried out from 2013 to 2014. A sample of 557 adults over 75 years old with osteoporotic hip fractures was recruited from the Orthogeriatric Unit of the León University Hospital (Spain)...
May 2018: Revista da Associação Médica Brasileira
Miles Berger, Katie J Schenning, Charles H Brown, Stacie G Deiner, Robert A Whittington, Roderic G Eckenhoff, Martin S Angst, Sinziana Avramescu, Alex Bekker, Marek Brzezinski, Greg Crosby, Deborah J Culley, Maryellen Eckenhoff, Lars I Eriksson, Lis Evered, Jim Ibinson, Richard P Kline, Andy Kofke, Daqing Ma, Joseph P Mathew, Mervyn Maze, Beverley A Orser, Catherine C Price, David A Scott, Brendan Silbert, Diansan Su, Niccolo Terrando, Dian-Shi Wang, Huafeng Wei, Zhoncong Xie, Zhiyi Zuo
As part of the American Society of Anesthesiology Brain Health Initiative goal of improving perioperative brain health for older patients, over 30 experts met at the fifth International Perioperative Neurotoxicity Workshop in San Francisco, CA, in May 2016, to discuss best practices for optimizing perioperative brain health in older adults (ie, >65 years of age). The objective of this workshop was to discuss and develop consensus solutions to improve patient management and outcomes and to discuss what older adults should be told (and by whom) about postoperative brain health risks...
October 9, 2018: Anesthesia and Analgesia
Egle Tamuleviciute-Prasciene, Kristina Drulyte, Greta Jurenaite, Raimondas Kubilius, Birna Bjarnason-Wehrens
The aim of this literature review was to evaluate existing evidence on exercise-based cardiac rehabilitation (CR) as a treatment option for elderly frail patients with valvular heart disease (VHD). Pubmed database was searched for articles between 1980 and January 2018. From 2623 articles screened, 61 on frailty and VHD and 12 on exercise-based training for patients with VHD were included in the analysis. We studied and described frailty assessment in this patient population. Studies reporting results of exercise training in patients after surgical/interventional VHD treatment were analyzed regarding contents and outcomes...
2018: BioMed Research International
Manu Shankar Hari, Charlotte Summers
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of the immune response to major surgery, and the ways in which it may be modulated to improve postoperative outcomes. RECENT FINDINGS: Data from patients who have undergone a variety of tissue injuries (surgery, burns, sepsis, trauma) have shown the presence of a conserved 'genomic storm' that alters the leukocyte transcriptome, with upregulation of the innate immune response and concomitant downregulation of the adaptive immune response...
October 6, 2018: Current Opinion in Critical Care
Kelly A Mills, Kristyn Donohue, Aathman Swaminathan, Jeannie-Marie Leoutsakos, Gwenn Smith, Jason Brandt
BACKGROUND: Deep brain stimulation (DBS) is effective for treatment of motor complications of dopaminergic therapy in Parkinson's disease (PD) but occasionally has been associated with multidomain cognitive decline. Patient- and caregiver-reported cognitive decline are clinically meaningful and increasingly recognized as important to consider when evaluating therapeutic interventions for PD. OBJECTIVE: The objective was to assess presurgical neuropsychological and clinical factors associated with PD patient- and caregiver-reported cognitive decline in two or more domains after DBS...
October 8, 2018: Journal of Clinical and Experimental Neuropsychology
M M Uygur, T Yoldemir, D G Yavuz
The interpretation of thyroid function tests should be cautiously made during the perimenopause and postmenopause period bearing in mind that physiologic changes do exist in this group of women in terms of secretion and metabolism of thyrotropin and thyroid hormones. Moreover the incidence of thyroid disorders increases in postmenopausal and elderly women. There is no consensus for screening postmenopausal women even though there is well-known evidence about the effect of thyroid status on cognitive function, cardiovascular risk, bone turnover, and longevity...
October 8, 2018: Climacteric: the Journal of the International Menopause Society
Ji-Shi Ye, Lei Chen, Ya-Yuan Lu, Shao-Qing Lei, Mian Peng, Zhong-Yuan Xia
AIMS: Increasing evidence indicates that neuroinflammatory and oxidative stress play two pivotal roles in cognitive impairment after surgery. Honokiol (HNK), as an activator of Sirtuin3 (SIRT3), has potential multiple biological functions. The aim of these experiments is to evaluate the effects of HNK on surgery/anesthesia-induced cognitive decline in mice. METHODS: Adult C57BL/6 mice received a laparotomy under sevoflurane anesthesia and HNK or SIRT3 inhibitor (3-TYP) treatment...
September 17, 2018: CNS Neuroscience & Therapeutics
Michał Tymowski, Wojciech Kaspera, Joanna Metta-Pieszka, Łukasz Zarudzki, Piotr Ładziński
OBJECTIVE: The aim of the study was to establish the usefulness of various neuropsychological tests in patients undergoing surgery due to low-grade glioma (LGG) involving supplementary motor area (SMA). PATIENTS AND METHODS: 21 patients diagnosed with LGG involving the SMA underwent, before and after surgery, screening tests (Mini Mental State Examination - MMSE, Montreal Cognitive Assessment - MoCA and Frontal Assessment Battery - FAB), tests to assess language functions (Addenbrook's Cognitive Examination-III - ACE-III, phonetic fluency tests and semantic fluency tests), tests to assess memory functions (Rey's 15-word test - RAVLT and Diagnostic Test for Brain Damage by Hillers- DCS), tests to assess executive functions (Wisconsin Card Sorting Test - WCST, Ruff Figural Fluency Test - RFFT and Trail Making Test)...
September 26, 2018: Clinical Neurology and Neurosurgery
Brett D Dufour, Jodi L McBride
Huntington's disease (HD) is a fatal genetic neurological disorder caused by a mutation in the human Huntingtin (HTT) gene. This mutation confers a toxic gain of function of the encoded mutant huntingtin (mHTT) protein, leading to widespread neuropathology including the formation of mHTT-positive inclusion bodies, gene dysregulation, reduced levels of adult dentate gyrus neurogenesis and ultimate neuron loss throughout many regions of the brain. Additionally, because HTT is ubiquitously expressed, several peripheral tissues are also affected...
October 4, 2018: Neurobiology of Disease
Antoine G M Aya, Pierre-Henri Pouchain, Hubert Thomas, Jacques Ripart, Philippe Cuvillon
BACKGROUND: While the incidence of postoperative delirium is high in aged hospitalized patients undergoing major surgery, little is known concerning patients undergoing ambulatory surgery. OBJECTIVE: To determine the incidence of postoperative delirium in aged patients after hospital discharge from an ambulatory surgery unit. DESIGN: Prospective observational study. PATIENTS: Elderly patients (≥75 years) scheduled for a surgical procedure on an ambulatory basis...
October 3, 2018: Journal of Clinical Anesthesia
Guillaume Besch, Lucie Vettoretti, Melanie Claveau, Nathalie Boichut, Nicolas Mahr, Yannis Bouhake, Ngai Liu, Thierry Chazot, Emmanuel Samain, Sebastien Pili-Floury
INTRODUCTION: Post-operative cognitive dysfunction (POCD) is frequent in patients older than 60 years undergoing major non-cardiac surgery, and increases both morbidity and mortality. Anesthetic drugs may exert neurotoxic effects and contribute to the genesis of POCD. The hypothesis of the POCD-ELA trial was that closed-loop target-controlled infusion of propofol and remifentanil could reduce the occurrence of POCD by decreasing the risk of excessive depth of anesthesia and the dose of anesthetic drugs...
October 2018: Medicine (Baltimore)
Sahar Salehi, Yvonne Brandberg, Elisabeth Åvall-Lundqvist, Chikako Suzuki, Hemming Johansson, Berit Legerstam, Henrik Falconer
PURPOSE: The health-related quality of life (HRQoL) outcomes after comprehensive surgical staging including infrarenal paraaortic lymphadenectomy in women with high-risk endometrial cancer (EC) are unknown. Our aim was to investigate the long-term HRQoL between robot-assisted laparoscopic surgery (RALS) and laparotomy (LT). PATIENTS AND METHODS: A total of 120 women with high-risk stage I-II EC were randomised to RALS or LT for hysterectomy, bilateral salpingoophorectomy, pelvic and infrarenal paraaortic lymphadenectomy in the previously reported Robot-Assisted Surgery for High-Risk Endometrial Cancer trial...
October 5, 2018: Acta Oncologica
Véronique Morel, Dominique Joly, Christine Villatte, Bruno Pereira, Gisèle Pickering
INTRODUCTION: Breast cancer affects 1 in 10 women worldwide, and mastectomy is a cause of chronic pain with neuropathic characteristics. N -methyl-D-aspartate receptor (NMDAR) antagonists such as ketamine, memantine, dextromethorphan or magnesium are used to treat refractory pain by blocking NMDAR. Oral memantine has been shown to prevent postmastectomy pain and cognitive impact and to maintain quality of life. Likewise, the present study is intended to assess the preventive effect of oral magnesium, administered ahead of mastectomy, on the development of neuropathic pain...
October 4, 2018: BMJ Open
Jennifer F Waljee, Kevin C Chung
Spasticity of the hand profoundly limits an individual's independent ability to accomplish self-care and activities of daily living. Surgical procedures should be tailored to patients' needs and functional ability, and even patients with severe cognitive injuries and poor upper extremity function may benefit from surgery to improve appearance and hygiene. Careful preoperative examination and planning are needed, and consideration is given to the potential unintended detrimental effect of a surgical procedure on hand function...
November 2018: Hand Clinics
Soeren Wagner, Joerg Quente, Sven Staedtler, Katharina Koch, Tanja Richter-Schmidinger, Johannes Kornhuber, Harald Ihmsen, Juergen Schuettler
BACKGROUND: The obstructive sleep apnea syndrome (OSAS) is characterized by temporary cerebral hypoxia which can cause cognitive dysfunction. On the other hand, hypoxia induced neurocognitive deficits are detectable after general anesthesia. The objective of this study was to evaluate the impact of a high risk of OSAS on the postoperative cognitive dysfunction after intravenous anesthesia. METHODS: In this single center trial between June 2012 and June 2013 43 patients aged 55 to 80 years with an estimated hospital stay of at least 3 days undergoing surgery were enrolled...
October 2, 2018: BMC Anesthesiology
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