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postoperative cognitive decline

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https://www.readbyqxmd.com/read/29164774/task-related-changes-in-degree-centrality-and-local-coherence-of-the-posterior-cingulate-cortex-after-major-cardiac-surgery-in-older-adults
#1
Jeffrey N Browndyke, Miles Berger, Patrick J Smith, Todd B Harshbarger, Zachary A Monge, Viral Panchal, Tiffany L Bisanar, Donald D Glower, John H Alexander, Roberto Cabeza, Kathleen Welsh-Bohmer, Mark F Newman, Joseph P Mathew
OBJECTIVES: Older adults often display postoperative cognitive decline (POCD) after surgery, yet it is unclear to what extent functional connectivity (FC) alterations may underlie these deficits. We examined for postoperative voxel-wise FC changes in response to increased working memory load demands in cardiac surgery patients and nonsurgical controls. EXPERIMENTAL DESIGN: Older cardiac surgery patients (n = 25) completed a verbal N-back working memory task during MRI scanning and cognitive testing before and 6 weeks after surgery; nonsurgical controls with cardiac disease (n = 26) underwent these assessments at identical time intervals...
November 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/29125432/association-between-baseline-cognitive-impairment-and-postoperative-delirium-in-elderly-patients-undergoing-surgery-for-adult-spinal-deformity
#2
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Postoperative delirium is common in elderly patients undergoing spine surgery and is associated with a longer and more costly hospital course, functional decline, postoperative institutionalization, and higher likelihood of death within 6 months of discharge. Preoperative cognitive impairment may be a risk factor for the development of postoperative delirium. The aim of this study was to investigate the relationship between baseline cognitive impairment and postoperative delirium in geriatric patients undergoing surgery for degenerative scoliosis...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29120931/perioperative-neurocognition-in-elderly-patients
#3
Huiqun Fu, Long Fan, Tianlong Wang
PURPOSE OF REVIEW: The extrinsic risk factors for postoperative cognitive disturbance have been a source of concern during the perioperative period, and these risk factors remain the subject of controversy. This review of recent studies focuses on the effect of these factors on postoperative cognitive disturbance during the perioperative period. RECENT FINDINGS: Impairment of cerebral autoregulation may predispose patients to intraoperative cerebral malperfusion, which may subsequently induce postoperative cognitive disturbance...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29117924/red-flags-in-epilepsy-surgery-identifying-the-patients-who-pay-a-high-cognitive-price-for-an-unsuccessful-surgical-outcome
#4
Sallie Baxendale, Pamela Thompson
Preoperative estimates of cognitive and seizure outcome must be as accurate as possible if the candidate is to make an informed decision about epilepsy surgery. Significant declines in memory function are reported in approximately 30% of temporal lobe surgery patients. The percentage varies according to the ways in which a postoperative deterioration is defined but since the majority of outcome studies do not take into account the patient's capacity to deteriorate if they are functioning at or close to the floor of a memory test prior to surgery, the published percentages may be an underrepresentation of the true extent of memory decline following epilepsy surgery...
November 5, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29100194/cognitive-decline-after-major-oncological-surgery-in-the-elderly
#5
M Plas, E Rotteveel, G J Izaks, J M Spikman, H van der Wal-Huisman, B van Etten, A R Absalom, M J E Mourits, G H de Bock, B L van Leeuwen
BACKGROUND: Elderly patients undergoing oncological surgery experience postoperative cognitive decline. The aims of this study were to examine the incidence of cognitive decline 3 months after surgery and identify potential patient-, disease- and surgery-related risk factors for postoperative cognitive decline in onco-geriatric patients. METHODS: A consecutive series of elderly patients (≥65 years) undergoing surgery for the removal of a solid tumour were included (n = 307)...
October 31, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29097068/evaluation-of-cognitive-function-following-transcatheter-aortic-valve-replacement
#6
Masieh Abawi, Rehana de Vries, Pieter R Stella, Pierfrancesco Agostoni, Dirk H M Boelens, Romy C van Jaarsveld, Charlotte S van Dongen, Pieter A F M Doevendans, Mariëlle H Emmelot-Vonk
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is associated with procedural-related neurological events and acute cognitive decline. However, data on the effect of TAVR on mid-term cognitive outcome are scarce. Therefore, we aimed to assess the impact of TAVR on mid-term cognitive outcome using different neurocognitive test batteries. METHODS: Patients with severe aortic valve stenosis scheduled for TAVR were enrolled. Cognitive assessment was performed at baseline and 4 months post-TAVR using an eight-word verbal-learning test ("Immediate Recall Memory Test" [IRMT], "Delayed Recall Memory Test" [DRMT], "Recognition of Verbal Information Test" [RVIT]), global cognitive function ("Mini Mental State Examination" [MMSE]), and executive function ("Trail Making Test" [TMT], "Clock-Drawing Test" [CDT])...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29058145/vitamin-status-and-the-development-of-postoperative-cognitive-decline-in-elderly-surgical-oncologic-patients
#7
Linda B M Weerink, Barbara L van Leeuwen, Sofie A M Gernaat, Anthony R Absalom, Monique G Huisman, Hanneke van der Wal-Huisman, Gerbrand J Izaks, Geertruida H de Bock
BACKGROUND: This study aimed to evaluate the influence that serum levels of vitamin B12, folate, and homocysteine have on the development of short-term postoperative cognitive decline in the elderly surgical oncology patient. METHODS: This study was part of a prospective cohort study focused on postoperative cognitive outcomes for patients 65 years of age or older undergoing surgery for a solid malignancy. Postoperative cognitive decline was defined as the change in the combined results of the Ruff Figural Fluency Test and the Trail-Making Test Parts A and B...
October 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29054389/optimizing-surgical-quality-datasets-to-care-for-older-adults-lessons-from-the-american-college-of-surgeons-nsqip-geriatric-surgery-pilot
#8
Julia R Berian, Lynn Zhou, Melissa A Hornor, Marcia M Russell, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Thomas N Robinson, Ronnie A Rosenthal
BACKGROUND: Surgical quality datasets can be better tailored toward older adults. The American College of Surgeons (ACS) NSQIP Geriatric Surgery Pilot collected risk factors and outcomes in 4 geriatric-specific domains: cognition, decision-making, function, and mobility. This study evaluated the contributions of geriatric-specific factors to risk adjustment in modeling 30-day outcomes and geriatric-specific outcomes (postoperative delirium, new mobility aid use, functional decline, and pressure ulcers)...
September 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29044209/cell-penetrating-interactomic-inhibition-of-nuclear-factor-kappa-b-in-a-mouse-model-of-postoperative-cognitive-dysfunction
#9
So Yeong Cheon, Jeong Min Kim, Eun Hee Kam, Chun-Chang Ho, Eun Jung Kim, Seungsoo Chung, Ji-Hyun Jeong, Diane Da-Hyun Lee, Sang-Won Lee, Bon-Nyeo Koo
Some patients experience impaired cognitive functioning after surgery, a phenomenon referred to as postoperative cognitive dysfunction (POCD). Signs of POCD are closely associated with the development of systemic or hippocampal inflammation. However, the precise pathophysiological mechanisms of prevention/treatment options for POCD still remain unclear. After injury, the transcriptional factor nuclear factor-kappa B (NF-κB) is thought to regulate or stimulate inflammation amplification. Therefore, we designed a cell-penetrating fusion protein called nt-p65-TMD, which inhibits NF-κB p65 activation by translocating into the nucleus...
October 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29039829/-factors-for-the-development-of-persistent-postoperative-cognitive-dysfunction-in-patients-undergoing-coronary-artery-bypass-surgery-under-extracorporeal-circulation
#10
O A Trubnikova, I V Tarasova, O V Maleva, E S Kagan, O L Barbarash, L S Barbarash
AIM: To analyze the factors contributing to the increased risk of persistent postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass surgery (CABS) under extracorporeal circulation (EC). SUBJECTS AND METHODS: 257 male patients aged 45 to 69 years with coronary heart disease (CHD) undergoing elective CABS under EC were examined. In addition to conventional clinical examination, all the patients underwent neuropsychological testing 3-5 days before, 7-14 days and 1 year after CABS...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#11
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/28985195/effects-of-dexamethasone-on-early-cognitive-decline-after-cardiac-surgery-a-randomised-controlled-trial
#12
Sandro Glumac, Goran Kardum, Lidija Sodic, Daniela Supe-Domic, Nenad Karanovic
BACKGROUND: Postoperative cognitive decline (POCD), a very common complication after cardiac surgery, is characterised by impairment of both memory function and intellectual ability as well as being associated with increased use of healthcare resources. The investigators focused on the role of the inflammatory response to a surgical procedure as a potential factor involved in the pathogenesis of POCD. OBJECTIVE: The use of prophylactic dexamethasone to attenuate the inflammatory response was hypothesised to reduce the risk of POCD...
November 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28984099/postoperative-delirium-and-postoperative-cognitive-dysfunction-updates-in-pathophysiology-potential-translational-approaches-to-clinical-practice-and-further-research-perspectives
#13
Marco Cascella, Maria R Muzio, Sabrina Bimonte, Arturo Cuomo, Jan G Jakobsson
Postoperative delirium, the onset of confusion/delirium during the early postoperative phase, is the most common post-operative complication in older adults and represents a medical emergency that requires immediate assessment and treatment. On the other hand, the term postoperative cognitive decline or dysfunction refers to a wide spectrum of clinical conditions featuring a decline in a variety of neuropsychological domains including memory, executive functioning, and speed of processing emerging week to months after anesthesia and surgery...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28911287/effect-of-sugammadex-versus-neostigmine-atropine-combination-on-postoperative-cognitive-dysfunction-after-elective-surgery
#14
C Batistaki, M Riga, F Zafeiropoulou, G Lyrakos, G Kostopanagiotou, P Matsota
This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years. The Mini-Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28890320/neuropsychologist-s-re-view-resective-versus-ablative-amygdalohippocampectomies
#15
REVIEW
Juri-Alexander Witt, Christian Hoppe, Christoph Helmstaedter
Pharmacoresistant mesial temporal lobe epilepsy (mTLE) represents the major indication for epilepsy surgery. Since epilepsy surgery is an elective treatment option, preserving cognition is a high priority. Given the essential role of temporomesial structures in declarative long-term memory formation, surgical treatment for mTLE is primarily associated with a risk of material-specific memory decline, but other cognitive domains may be affected as well. The major determinants for the neuropsychological outcome are the functional integrity of surgically affected tissues, the functional reserve capacities of the remnant brain, the postoperative seizure outcome, as well as the quantitative and qualitative changes of antiepileptic drugs...
September 1, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28881691/critical-role-of-matrix-metallopeptidase-9-in-postoperative-cognitive-dysfunction-and-age-dependent-cognitive-decline
#16
Jiangjiang Bi, Weiran Shan, Ailin Luo, Zhiyi Zuo
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a significant clinical syndrome. Neuroinflammation is an important pathological process for POCD. However, it is not clear how systemic inflammation induced by surgery on peripheral tissues or organs is transmitted into the brain. We determined whether matrix metallopeptidase 9 (MMP9), a protein that can increase blood-brain barrier permeability, is critical in this transmission. The role of MMP9 in age-dependent cognitive decline was also determined...
August 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28854542/association-between-delirium-and-cognitive-change-after-cardiac-surgery
#17
A C Sauër, D S Veldhuijzen, T H Ottens, A J C Slooter, C J Kalkman, D van Dijk
Background: Previous studies provide inconsistent data on whether postoperative delirium (POD) is a risk factor for postoperative cognitive decline (POCD). We thus investigated the relationship between POD and cognitive change after cardiac surgery and assessed the relationship between preoperative cognitive domain scores and POD. Methods: Postoperative delirium was assessed with the Confusion Assessment Method (CAM) adapted for the intensive care unit and the conventional CAM accompanied by chart review...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28854532/association-of-intraoperative-changes-in-brain-derived-neurotrophic-factor-and-postoperative-delirium-in-older-adults
#18
J Wyrobek, A LaFlam, L Max, J Tian, K J Neufeld, K M Kebaish, J D Walston, C W Hogue, L H Riley, A D Everett, C H Brown
Background: Delirium is common after surgery, although the aetiology is poorly defined. Brain-derived neurotrophic factor (BDNF) is a neurotrophin important in neurotransmission and neuroplasticity. Decreased levels of BDNF have been associated with poor cognitive outcomes, but few studies have characterized the role of BDNF perioperatively. We hypothesized that intraoperative decreases in BDNF levels are associated with postoperative delirium. Methods: Patients undergoing spine surgery were enrolled in a prospective cohort study...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28851286/influence-of-the-postoperative-inflammatory-response-on-cognitive-decline-in-elderly-patients-undergoing-on-pump-cardiac-surgery-a-controlled-prospective-observational-study
#19
Endre Nemeth, Katalin Vig, Kristof Racz, Kinga B Koritsanszky, Klara I Ronkay, Fumiko P Hamvas, Csaba Borbély, Ajandek Eory, Bela Merkely, Janos Gal
BACKGROUND: The role of non-infective inflammatory response (IR) in the aetiology of postoperative cognitive dysfunction (POCD) is still controversial. The aim of this controlled, prospective observational study was to assess the possible relationship between the grade of IR, defined by procalcitonin (PCT) changes, and development of POCD related to cardiac surgery. METHODS: Forty-two patients, who were ≥ 60 years of age and scheduled for elective cardiac surgery, were separated into the low inflammatory (LIR) and high inflammatory (HIR) response groups based on their PCT levels measured on the first postoperative day...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28816833/perioperative-use-of-erythromycin-reduces-cognitive-decline-after-coronary-artery-bypass-grafting-surgery-a-pilot-study
#20
Evanthia Thomaidou, Helena Argiriadou, Georgios Vretzakis, Kalliopi Megari, Nikolaos Taskos, Georgios Chatzigeorgiou, Kyriakos Anastasiadis
OBJECTIVES: Adverse neurologic outcome can be a debilitating complication after cardiac surgery. The aim of this study was to investigate the potential neuroprotective action of erythromycin, a well known antibiotic agent, regarding postoperative cognitive decline in patients undergoing cardiac surgery. METHODS: Forty patients scheduled for elective coronary artery bypass grafting surgery were prospectively randomly assigned in 2 groups: the erythromycin group (n = 19) who received erythromycin at a dose of 25 mg/kg before and after surgery and the control group (n = 21) who did not receive it...
September 2017: Clinical Neuropharmacology
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