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Jing-Yu Xiao, Bing-Rui Xiong, Wen Zhang, Wen-Chang Zhou, Hui Yang, Feng Gao, Hong-Bing Xiang, Anne Manyande, Xue-Bi Tian, Yu-Ke Tian
AIM: Multifactors contribute to the development of postoperative cognitive dysfunction (POCD), of which the most important mechanism is neuroinflammation. Prostaglandin E2 (PGE2) is a key neuroinflammatory molecule and could modulate hippocampal synaptic transmission and plasticity. This study was designed to investigate whether PGE2 and its receptors signaling pathway were involved in the pathophysiology of POCD. METHODS: Sixteen-month old male C57BL/6J mice were exposed to laparotomy...
February 27, 2018: CNS Neuroscience & Therapeutics
Ruixue Hou, Hong Wang, Lianhua Chen, Yimin Qiu, Shitong Li
Objectives: Clinical observation, as well as randomized controlled trials, indicated an increasing rate of postoperative cognitive dysfunction (POCD) with increasing depth of general anesthesia. However, the findings are subject to bias due to varying degree of analgesia. In this trial, we compared the rate of POCD between patients receiving light versus high anesthesia while holding analgesia comparable using nerve block. Methods: Elderly patients (≧60 years) receiving elective total knee replacement were randomized to receive the surgery under general anesthesia at BIS 40-50 (LOBIS group) or BIS 55-65 (HIBIS group)...
February 2018: Brain and Behavior
Wenyao Li, Qing Chai, Hongwei Zhang, Jing Ma, Chengfen Xu, Jifu Dong, Xianghua Wei, Zhiyi Wang, Kexian Zhang
Objective Postoperative cognitive dysfunction (POCD) is common after surgery in elderly patients and is associated with high morbidity. The molecular mechanisms responsible for POCD are unknown. Minocycline, an inhibitor of microglial activation, may be useful in treating and preventing POCD. We explored whether minocycline can inhibit microglial activation and prevent POCD in aged rats as a surgery model. Methods Rats aged 18 to 20 months were randomly allocated to the following groups: naïve, abdominal surgery alone, or minocycline injection before abdominal surgery...
January 1, 2018: Journal of International Medical Research
Sandro Glumac, Goran Kardum, Nenad Karanović
BACKGROUND A recent study reported that patients with higher cortisol levels on the 1st postoperative morning after cardiac surgery exhibited an increased risk of early postoperative cognitive decline (POCD). Therefore, we conducted the current study to gain further insight into the stress response to a surgical procedure as a potential risk factor for early POCD after cardiac surgery. MATERIAL AND METHODS This prospective cohort study enrolled 125 patients undergoing elective cardiac surgery with or without cardiopulmonary bypass (CPB)...
February 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lan Wei, Minmin Yao, Zhimeng Zhao, Hui Jiang, Shengjin Ge
BACKGROUND: Silent Information Regulator 1 (Sirt1) and apoptosis play key roles in postoperative cognitive dysfunction (POCD). Consuming a high-fat diet (HFD), a prevalent type of diet in modern society, has been increasingly recognized as contributing to neurodegenerative diseases. Although Sirt1 and apoptosis are significant responders to HFD in the brain, little is known regarding the functional correlations between HFD and POCD. METHODS: Thirty-two aged C57BL/6 male mice were randomly divided into 2 groups: an ad libitum (AL) group (fed a regular diet) and high-fat diet (HF) group (fed a high-fat diet)...
February 13, 2018: BMC Anesthesiology
Insa Feinkohl, Georg Winterer, Tobias Pischon
BACKGROUND: Lipid imbalance is linked to age-related cognitive impairment, but its role in postoperative cognitive dysfunction (POCD) is unknown. Here, we present a systematic review and meta-analysis on dyslipidaemia, lipid-lowering treatment and POCD risk. METHODS: PubMed, Ovid SP and Cochrane databases were searched for longitudinal studies that reported on associations of any measure of dyslipidaemia and/or lipid-lowering treatment with POCD as relative risks (RRs) or ORs...
February 2, 2018: Journal of Epidemiology and Community Health
Andres Zorrilla-Vaca, Ryan Healy, Michael C Grant, Brijen Joshi, Lucia Rivera-Lara, Charles Brown, Marek A Mirski
PURPOSE: Although evidence from observational studies in a variety of clinical settings supports the utility of cerebral oximetry as a predictor of outcomes, prospective clinical trials thus far have reported conflicting results. This systematic review and meta-analysis was designed to evaluate the influence of management associated with intraoperative cerebral oximetry on postoperative outcomes. The primary outcome was postoperative cognitive dysfunction (POCD), with secondary outcomes that included postoperative delirium, length of intensive care unit (ICU) stay, and hospital length of stay (LOS)...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mengya Cao, Jiakai Fang, Xueqin Wang, Yi Wang, Kaiming Duan, Feng Ye, Wen Ouyang, Jianbin Tong
The upstream signal molecule modulating neuro-inflammation and synaptic changes during the pathogenesis of postoperative cognitive dysfunction (POCD) is still elusive. Here, we examined the effects and mechanisms of energy sensor AMP-activated protein kinase (AMPK) in the pathogenesis of POCD. Our data showed that surgery significantly increased the expression of p-AMPK in aged rats (p < 0.05), but not in adult rats (p > 0.05). Moreover, inhibiting AMPK activation via compound C during operation significantly improved surgery-induced impairment of the learning and memory of aged rats in water maze (p < 0...
April 1, 2018: Brain Research
Vsevolod V Kuzkov, Maxim Y Obraztsov, Oleg Y Ivashchenko, Nadezhda Y Ivashchenko, Valery M Gorenkov, Mikhail Y Kirov
OBJECTIVE: Carotid endarterectomy (CEA) is effective for the prevention of stroke, yet can be associated with a postoperative cognitive dysfunction (POCD) that may be affected by the type of anesthesia. The aim of the study was to compare the effects of total intravenous anesthesia (TIVA) with propofol to volatile induction and maintenance of anesthesia (VIMA) with sevoflurane on cerebral tissue oxygen saturation (SctO2) and POCD. DESIGN: Single-center, pilot randomized prospective study...
January 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Zhipeng Wu, Mei Zhang, Zhenhong Zhang, Wei Dong, Qingben Wang, Juan Ren
β-amyloid (Aβ) and Tau proteins are biomarkers of Alzheimer's disease neuropathogenesis. We hypothesized that they are also potential biomarkers for postoperative cognitive dysfunction (POCD). The present study was designed to evaluate the use of the Aβ-42/Tau ratio for the diagnosis of POCD in patients undergoing hip/knee replacement surgery. A total of 80 patients who underwent total hip/knee replacement surgery were grouped into POCD or non-POCD patients at 7 days, 1 and 3 months after surgery, according to a z-score recommended by the international study of POCD...
January 2018: Experimental and Therapeutic Medicine
Cristina Zarbo, Michela Brivio, Agostino Brugnera, Chiara Malandrino, Gaetano Trezzi, Massimo Rabboni, Emi Bondi, Angelo Compare, Luigi Frigerio
The original version of this article unfortunately contained a mistake. The given names and family names of all authors were interchanged.
January 31, 2018: Archives of Gynecology and Obstetrics
Tomohisa Yamamoto, Tatsushige Iwamoto, Seishi Kimura, Shinichi Nakao
BACKGROUND: Postoperative cognitive dysfunction (POCD) is likely to occur in elderly people, who often suffer from cerebral hypoperfusion and white matter lesions even in the absence of cerebral infarctions. METHODS: Thirty-two adult male rats were randomly assigned to one of four groups: the cerebral normoperfusion + normotension group (n = 8), cerebral normoperfusion + hypotension group (n = 8), chronic cerebral hypoperfusion (CCH) + normotension group (n = 8), and CCH + hypotension group (n = 8)...
January 25, 2018: Journal of Anesthesia
Chun-Long Zuo, Chun-Man Wang, Jin Liu, Ting Shen, Jiang-Ping Zhou, Xin-Rui Hao, Yi-Zhao Pan, Hua-Cheng Liu, Qing-Quan Lian, Han Lin
AIMS: Isoflurane may not only accelerate the process of Alzheimer's disease (AD), but increase the risk of incidence of postoperative cognitive dysfunction (POCD). However, the underlying mechanisms remain unknown. This study was designed to investigate whether isoflurane contributed to the POCD occurrence through A1 adenosine receptor (A1AR) in aged mice. METHODS: We assessed cognitive function of mice with Morris water maze (MWM) and then measured expression level of two AD biomarkers (P-tau and Aβ) and a subtype of the NMDA receptor (NR2B) in aged wild-type (WT) and homozygous A1 adenosine receptor (A1AR) knockout (KO) mice at baseline and after they were exposed to isoflurane (1...
January 17, 2018: CNS Neuroscience & Therapeutics
Yongbo Ding, Cunxian Shi, Linjing Chen, Piliang Ma, Kezhong Li, Jin Jin, Qingfeng Zhang, Aizhi Li
The present study investigated the effects of andrographolide on postoperative cognitive dysfunction (POCD) in aged rats to gain insight of the underlying mechanism, which may provide theoretical basis for the clinical application of andrographolide to prevent POCD in older patients. Thirty aged male rats were randomly assigned to 3 groups: Control, model and andrographolide groups. The Morris water maze test was used to examine the spatial memory and learning ability of the rats postoperatively. The histological alterations of neuronal cells in the hippocampus were visualized by H&E staining...
December 2017: Oncology Letters
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
Zhijie Zhang, Muhuo Ji, Yanlin Liao, Jianjun Yang, Jun Gao
Postoperative cognitive dysfunction (POCD) is a clinical syndrome characterized by varying degrees of cognitive functional decline in patients following major surgery. Inflammation and a dysregulated innate immune system exert broad effects in the periphery and central nervous system, yet the mechanisms underlying POCD remain poorly understood and without effective therapy. It has been reported that modulation of the dysregulated inflammatory response with low‑dose lipopolysaccharide (LPS) preconditioning, a phenomenon additionally referred to as endotoxin tolerance, has the potential to reduce neuroinflammation, blood‑brain barrier disruption, and cognitive impairment in a number of disease states...
January 2, 2018: Molecular Medicine Reports
Mohammad Reza Habibi, Valiollah Habibi, Ali Habibi, Aria Soleimani
The true influence of the perioperative intravenous lidocaine on the development of postoperative cognitive deficit (POCD) in coronary artery bypass grafting (CABG) remains controversial. The principal aim is to undertake a meta-regression to determine whether moderator variables mediate the relationship between lidocaine and POCD. Areas covered: We searched the Web of Science, PubMed database, Scopus and the Cochrane Library database (up to June 2017) and systematically reviewed a list of retrieved articles...
January 9, 2018: Expert Review of Clinical Pharmacology
Elsbeth Heinzelmann
When an innovative technology is going to be implemented in hospitals, medical practices or pharmacies, it often does not appear really new to researchers. It is the implementation itself and the domain where it is used that are at the core of innovation. That's why the SWISS SYMPOSIUM in Point-of-Care Diagnostics (POCD) brings together key stakeholders from research and industry to clinical settings and patient care to exchange knowledge and experience and to stimulate activities in POCD.
December 1, 2017: Chimia
Xing Lu, Xin Jin, Suwei Yang, Yanfei Xia
STUDY OBJECTIVE AND BACKGROUND: To comprehensively evaluate the associations between the depth of anesthesia and postoperative delirium (POD) or postoperative cognitive dysfunction (POCD). DESIGN: Using the Cochrane evaluation system, the included studies were conducted with quality assessment. DATA SOURCES: We searched Cochrane library, Embase and PubMed databases without language restriction. The retrieval time is up to August 2017. ELIGIBILITY CRITERIA: According to the PRISMA guideline, the results associated with POCD and POD separately were compared between low and high bispectral index (BIS) groups under fixed effects model or random effects model...
March 2018: Journal of Clinical Anesthesia
Ho Won Kang, Hae Do Jung, Joo Yong Lee, Jong Kyou Kwon, Seong Uk Jeh, Kang Su Cho, Won Sik Ham, Young Deuk Choi
BACKGROUND: Little is known about the preoperative predictive factors that could identify subsets of favorable patients who can be possibly cured with robot-assisted radical prostatectomy (RARP) alone in locally advanced prostate cancer (LAPCa). Our study was designed to identify clinical predictors of pathologic organ-confined disease (pOCD) in RARP setting. METHODS: Between 2007 and 2013, clinicopathological and oncological data from 273 consecutive men undergoing robot-assisted RP with extended PLND for clinically LAPCa were reviewed in a single-institution, retrospectively...
December 20, 2017: Asian Journal of Surgery
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