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postoperative cognitive decline

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https://www.readbyqxmd.com/read/28089142/bedside-monitoring-of-cerebral-energy-state-during-cardiac-surgery-a-novel-approach-utilizing-intravenous-microdialysis
#1
Simon Mölström, Troels H Nielsen, Claus Andersen, Carl H Nordström, Palle Toft
OBJECTIVES: This study investigated whether the lactate-to-pyruvate (LP) ratio obtained by microdialysis (MD) of the cerebral venous outflow reflected a derangement of global cerebral energy state during cardiopulmonary bypass (CPB). DESIGN: Interventional, prospective, randomized study. SETTING: Single-center, university teaching hospital. PARTICIPANTS: The study included 10 patients undergoing primary, elective coronary artery bypass grafting...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28087827/neuropsychological-outcome-following-frontal-lobectomy-for-pharmacoresistant-epilepsy-in-adults
#2
Robyn M Busch, Darlene P Floden, Lisa Ferguson, Shamseldeen Mahmoud, Audrina Mullane, Stephen Jones, Lara Jehi, William Bingaman, Imad M Najm
OBJECTIVE: This retrospective cohort study characterized cognitive and motor outcomes in a large sample of adults who underwent frontal lobe resections for treatment of pharmacoresistant epilepsy. METHODS: Ninety patients who underwent unilateral frontal lobe resection for epilepsy (42 language-dominant hemisphere/48 nondominant hemisphere) between 1989 and 2014 completed comprehensive preoperative and postoperative neuropsychological evaluations that included measures of verbal and nonverbal intellectual functioning, attention/working memory, processing speed, language, executive functioning, verbal and visual memory, and motor functioning...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28086911/enhanced-neuroinflammation-mediated-by-dna-methylation-of-the-glucocorticoid-receptor-triggers-cognitive-dysfunction-after-sevoflurane-anesthesia-in-adult-rats-subjected-to-maternal-separation-during-the-neonatal-period
#3
Yangzi Zhu, Yu Wang, Rui Yao, Ting Hao, Junli Cao, He Huang, Liwei Wang, Yuqing Wu
BACKGROUND: Mounting evidence indicates that children who experience abuse and neglect are prone to chronic diseases and premature mortality later in life. One mechanistic hypothesis for this phenomenon is that early life adversity alters the expression or functioning of the glucocorticoid receptor (GR) throughout the course of life and thereby increases sensitivity to inflammatory stimulation. An exaggerated pro-inflammatory response is generally considered to be a key cause of postoperative cognitive dysfunction (POCD)...
January 7, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28078842/remission-effect-of-vitamin-c-on-isoflurane-induced-apoptosis-and-its-mechanism
#4
J Hu, B F Gao, H Q Li, Z Z Zhang, Y L Lei, G Q Sun, D M Guo
This study aims to discuss the remission effect of vitamin C on isoflurane-induced apoptosis of rats and its possible mechanism of action, to provide a theoretical basis for postoperative cognitive impairment. Reactive oxygen species (ROS) detection, adenosine triphosphate (ATP) test, MTT method and Morris water maze were applied for detection tests. For data statistics, double factor analysis of variance (ANOVA) and post hoc Bonferroni test were adopted. It was found that vitamin C could slow down the isoflurane-induced accumulation of ROS in H4-APP cells; moreover, it could relieve the activation of caspase-3 and increase cell survival rate to inhibit the occurrence of apoptosis, indicating that ROS was the source of cell toxicity...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28039082/intraoperative-cerebral-oxygenation-oxidative-injury-and-delirium-following-cardiac-surgery
#5
Marcos G Lopez, Pratik Pandharipande, Jennifer Morse, Matthew S Shotwell, Ginger L Milne, Mias Pretorius, Andrew D Shaw, L Jackson Roberts, Frederic T Billings
BACKGROUND: Delirium affects 20-30% of patients after cardiac surgery and is associated with increased mortality and persistent cognitive decline. Hyperoxic reperfusion of ischemic tissues increases oxidative injury, but oxygen administration remains high during cardiac surgery. We tested the hypothesis that intraoperative hyperoxic cerebral reperfusion is associated with increased postoperative delirium and that oxidative injury mediates this association. METHODS: We prospectively measured cerebral oxygenation with bilateral oximetry monitors in 310 cardiac surgery patients, quantified intraoperative hyperoxic cerebral reperfusion by measuring the magnitude of cerebral oxygenation above baseline after any ischemic event, and assessed patients for delirium twice daily in the ICU following surgery using the confusion assessment method for ICU (CAM-ICU)...
December 27, 2016: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28033253/postoperative-cognitive-changes-after-total-knee-arthroplasty-under-regional-anesthesia
#6
Young-Tae Jeon, Byung-Gun Kim, Young Ho Park, Hye-Min Sohn, Jungeun Kim, Seung Chan Kim, Seong Soo An, SangYun Kim
BACKGROUND: The type of postoperative cognitive decline after surgery under spinal anesthesia is unknown. We investigated the type of postoperative cognitive decline after total knee arthroplasty (TKA). Neuropsychological testing was conducted and the changes in cerebrospinal fluid (CSF) biomarkers after surgery were evaluated. METHODS: Fifteen patients who required bilateral TKA at a 1-week interval under spinal anesthesia were included. Neuropsychological tests were performed twice, once the day before the first operation and just before the second operation (usually 1 week after the first test) to determine cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28024850/volume-of-subclinical-embolic-infarct-correlates-to-long-term-cognitive-changes-after-carotid-revascularization
#7
Wei Zhou, Brittanie D Baughman, Salil Soman, Max Wintermark, Laura C Lazzeroni, Elizabeth Hitchner, Jyoti Bhat, Allyson Rosen
OBJECTIVE: Carotid intervention is safe and effective in stroke prevention in appropriately selected patients. Despite minimal neurologic complications, procedure-related subclinical microemboli are common and their cognitive effects are largely unknown. In this prospective longitudinal study, we sought to determine long-term cognitive effects of embolic infarcts. METHODS: The study recruited 119 patients including 46% symptomatic patients who underwent carotid revascularization...
December 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28006786/neuropsychological-outcome-in-subthalamic-nucleus-stimulation-surgeries-with-electrodes-passing-through-the-caudate-nucleus
#8
Cihan Isler, Angela Albi, Frédéric L W V J Schaper, Yasin Temel, Annelien Duits
BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson disease (PD) is associated with postoperative cognitive decline. One of the proposed underlying mechanisms is the surgical procedure with the lead trajectory penetrating the caudate nucleus. OBJECTIVE: To study whether penetration of the caudate nucleus affects neuropsychological outcome. METHODS: Neuropsychological and imaging data of 30 PD patients who underwent bilateral STN DBS were analysed...
December 23, 2016: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28002537/cerebral-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy-in-acromegalic-patient-with-severe-headache
#9
LuminiŢa Nicoleta Cima, Simona Vasilica Fica, Alice Ioana Albu, Ioana Maria Lambrescu, Ioana SmărăndiŢa Lăcău, Bogdan Ovidiu Popescu, Mihaela Gherghiceanu, Corin Virgil Badiu, Carmen Gabriela Barbu
A 68-year-old female patient was admitted in our clinic with severe frontal bilateral headache, dizziness, depression and cognitive decline in the context of a previously diagnosed acromegaly. She also had high blood pressure, dyslipidemia, secondary diabetes mellitus. Acromegaly was caused by a growth hormone (GH) secreting-pituitary macroadenoma, so a transsphenoidal surgery was performed. The postoperative magnetic resonance imaging (MRI) scan revealed a 20÷22÷25 mm pituitary mass remnant and medical therapy with somatostatin analogues (SSAs) was started...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27987229/neuronal-damage-biomarkers-in-the-identification-of-patients-at-risk-of-long-term-postoperative-cognitive-dysfunction-after-cardiac-surgery
#10
W F Kok, J Koerts, O Tucha, T W L Scheeren, A R Absalom
Biomarkers of neurological injury can potentially predict postoperative cognitive dysfunction. We aimed to identify whether classical neuronal damage-specific biomarkers, including brain fatty acid-binding protein, neuron-specific enolase and S100 calcium-binding protein β, as well as plasma-free haemoglobin concentration as a measure of haemolysis, could be used to predict the risk of long-term cognitive decline after coronary artery bypass grafting with or without cardiopulmonary bypass. We assessed cognitive function using the CogState brief computerised cognitive test battery at 3 months and at 15 months after surgery...
December 17, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27940456/perioperative-cognitive-protection
#11
C Brown, S Deiner
There is significant evidence that many older surgical patients experience at least a transient decrease in cognitive function. Although there is still equipoise regarding the degree, duration, and mechanism of cognitive dysfunction, there is a concurrent need to provide best-practice clinical evidence. The two major cognitive disorders seen after surgery are postoperative delirium and postoperative cognitive dysfunction. Delirium is a public health problem; millions of dollars are spent annually on delirium-related medical resource use and prolonged hospital stays...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27940378/ppar%C3%AE-activation-ameliorates-postoperative-cognitive-decline-probably-through-suppressing-hippocampal-neuroinflammation-in-aged-mice
#12
Zhijie Zhang, Hongmei Yuan, Huatang Zhao, Bin Qi, Fayin Li, Lijun An
Neuroinflammation plays a key role in many neurodegenerative disorders, including postoperative cognitive decline (POCD). Growing evidence has demonstrated that activation of the peroxisome proliferator-activated receptor-γ (PPARγ) attenuates the inflammatory response and improves cognitive dysfunction associated with many neuropsychiatric disorders. We hypothesize that down-regulation of PPARγ is linked to neuroinflammation and the subsequent cognitive deficits observed in an animal model of POCD. In the present study, the POCD animal model was established by performing an exploratory laparotomy under isoflurane anesthesia in 20-month-old male C57BL/6 mice...
February 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/27930598/the-anhepatic-phase-extended-by-temporary-portocaval-shunt-does-not-affect-anesthetic-sensitivity-and-postoperative-cognitive-function-a-case-control-study
#13
Young Gon Son, Sung Hye Byun, Jong Hae Kim
Temporary portocaval shunt (TPCS) prolongs the duration of the anhepatic phase, during which anesthetic sensitivity is highest among the 3 phases of living donor liver transplantation (LDLT). Cognitive dysfunction has been associated with increased anesthetic sensitivity and poor hepatic function. Therefore, we assessed anesthetic sensitivity to desflurane and perioperative cognitive function in patients undergoing LDLT, in whom the duration of the anhepatic phase was extended by TPCS to test the hypothesis that the prolonged anhepatic phase increases anesthetic sensitivity and causes postoperative cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27884107/association-between-changes-in-cerebral-grey-matter-volume-and-postoperative-cognitive-dysfunction-in-elderly-patients-study-protocol-for-a-prospective-observational-cohort-study
#14
Nicolai Goettel, Panagiota Mistridis, Manfred Berres, Julia Reinhardt, Christoph Stippich, Andreas U Monsch, Luzius A Steiner
BACKGROUND: Cognitive decline is frequently observed in elderly patients after major surgery. The pathophysiology of postoperative cognitive dysfunction (POCD) remains unclear. The aim of our investigation is to identify potential associations between brain volume change and POCD in elderly patients undergoing major surgery. METHODS: This is a prospective observational cohort study approved by the regional ethics board. We intend to compare specific brain volumes (hippocampus, lateral ventricle, total grey matter volume, regional cortical thickness) on magnetic resonance imaging and cognitive functions determined by a neuropsychological assessment battery in 70 study participants aged ≥65 years before and 3 and 12 months after major noncardiac surgery...
November 25, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27836394/pre-and-postoperative-neurocognitive-deficits-in-brain-tumor-patients-assessed-by-a-computer-based-screening-test
#15
Markus Hoffermann, Lukas Bruckmann, Kariem Mahdy Ali, Karla Zaar, Alexander Avian, Gord von Campe
Neurocognitive assessment becomes increasingly important in neuro-oncology. The presence and degree of neurocognitive deficits in patients with brain tumors appear to be important not only as outcome measures but also in treatment planning and as possible prognostic markers for tumor-progression. Common screening methods for neurocognitive deficits are often insufficient in uncovering subtle changes or harbor the risk of being observer-dependent and time-consuming. We present data of brain tumor patients screened by a computer-based neurocognitive assessment tool before and after surgery...
February 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#16
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27815406/estimating-risk-of-word-finding-problems-in-adults-undergoing-epilepsy-surgery
#17
Robyn M Busch, Darlene P Floden, Brigid Prayson, Jessica S Chapin, Kevin H Kim, Lisa Ferguson, William Bingaman, Imad M Najm
OBJECTIVE: This retrospective, observational study examined the frequency and magnitude of change in naming ability as a function of side/site of epilepsy surgery and identified predictive factors to assist clinicians in identifying patients at low, moderate, or high risk of postoperative naming decline. METHODS: A total of 875 adults with pharmacoresistant epilepsy (454 left/421 right; 763 temporal/87 frontal/25 posterior quadrant) met inclusion criteria and completed the Boston Naming Test before and after surgery...
November 29, 2016: Neurology
https://www.readbyqxmd.com/read/27809575/a-systematic-review-of-postoperative-cognitive-decline-following-open-and-endovascular-aortic-aneurysm-surgery
#18
R A Benson, B A Ozdemir, D Matthews, I M Loftus
OBJECTIVES Postoperative cognitive decline (POCD) is a well-recognised neurological phenomenon following major surgery. Most commonly seen in elderly patients, it has direct links to increased long-term morbidity and reduced quality of life. Its incidence following open and endovascular abdominal and thoracic aneurysm surgery is unclear. The purpose of this systematic review is to collate available evidence for POCD following abdominal and thoracic aortic surgery, and to identify continuing controversies directing future research...
November 4, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27790135/nox-2-mediated-phenotype-loss-of-hippocampal-parvalbumin-interneurons-might-contribute-to-postoperative-cognitive-decline-in-aging-mice
#19
Li-Li Qiu, Dan Luo, Hui Zhang, Yun S Shi, Yan-Jun Li, Dan Wu, Jiang Chen, Mu-Huo Ji, Jian-Jun Yang
Postoperative cognitive decline (POCD) is a common complication following anesthesia and surgery, especially in elderly patients; however, the precise mechanisms of POCD remain unclear. Here, we investigated whether nicotinamide adenine dinucleotide phosphate (NADPH) oxidase mediated-abnormalities in parvalbumin (PV) interneurons play an important role in the pathophysiology of POCD. The animal model was established using isoflurane anesthesia and exploratory laparotomy in 16-month-old male C57BL/6 mice. For interventional experiments, mice were chronically treated with the NADPH oxidase inhibitor apocynin (APO)...
2016: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/27764047/the-future-of-postoperative-quality-of-recovery-assessment-multidimensional-dichotomous-and-directed-to-individualize-care-to-patients-after-surgery
#20
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
December 2016: Current Opinion in Anaesthesiology
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