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Post operative cognitive decline

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https://www.readbyqxmd.com/read/28750249/fall-risk-and-function-in-older-women-after-gynecologic-surgery
#1
Karen L Miller, Holly E Richter, Charles S Graybill, Leigh A Neumayer
PURPOSE OF STUDY: To examine change in balance-related fall risk and daily functional abilities in the first 2 post-operative weeks and up to 6 weeks after gynecologic surgery. MATERIALS AND METHODS: Prospective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre- and post-operatively daily for 1 week and twice the second week...
July 19, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28743056/apigenin-attenuates-isoflurane-induced-cognitive-dysfunction-via-epigenetic-regulation-and-neuroinflammation-in-aged-rats
#2
Lin Chen, Wenji Xie, Wenqin Xie, Weiqiang Zhuang, Changcheng Jiang, Naizhen Liu
PURPOSE OF THE RESEARCH: Post operational cognitive dysfunction (POCD) occurs in patients after anesthesia and surgery. Abnormal histone acetylation and neuroinflammation are key factors in the pathogenesis of cognitive impairment. Apigenin not only has an anti-inflammatory activity but also modifies histone acetylation. We aimed to investigate whether apigenin can attenuate isoflurane exposure-induced cognitive decline by regulating histone acetylation and inflammatory signaling. MATERIALS AND METHODS: Spatial learning and memory were assessed by Morris water maze test...
July 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28687375/post-operative-stereotactic-radiosurgery-versus-observation-for-completely-resected-brain-metastases-a-single-centre-randomised-controlled-phase-3-trial
#3
RANDOMIZED CONTROLLED TRIAL
Anita Mahajan, Salmaan Ahmed, Mary Frances McAleer, Jeffrey S Weinberg, Jing Li, Paul Brown, Stephen Settle, Sujit S Prabhu, Frederick F Lang, Nicholas Levine, Susan McGovern, Erik Sulman, Ian E McCutcheon, Syed Azeem, Daniel Cahill, Claudio Tatsui, Amy B Heimberger, Sherise Ferguson, Amol Ghia, Franco Demonte, Shaan Raza, Nandita Guha-Thakurta, James Yang, Raymond Sawaya, Kenneth R Hess, Ganesh Rao
BACKGROUND: After brain metastasis resection, whole brain radiotherapy decreases local recurrence, but might cause cognitive decline. We did this study to determine if stereotactic radiosurgery (SRS) to the surgical cavity improved time to local recurrence compared with that for surgical resection alone. METHODS: In this randomised, controlled, phase 3 trial, we recruited patients at a single tertiary cancer centre in the USA. Eligible patients were older than 3 years, had a Karnofsky Performance Score of 70 or higher, were able to have an MRI scan, and had a complete resection of one to three brain metastases (with a maximum diameter of the resection cavity ≤4 cm)...
August 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28676310/an-investigation-into-the-effects-and-prognostic-factors-of-cognitive-decline-following-subthalamic-nucleus-stimulation-in-patients-with-parkinson-s-disease
#4
Taro Nimura, Ken-Ichi Nagamatsu, Tadashi Ando, Arifumi Matsumoto, Kinya Hisanaga, Teiji Tominaga
We retrospectively investigated the effects of subthalamic nucleus stimulation (STN-DBS) on new postoperative onset of cognitive decline and prognostic factors for advanced Parkinson's disease (PD). We studied 39 PD patients who had received bilateral STN-DBS. Clinical symptoms, cognitive function, psychiatric function, and health-related quality of life (HRQOL) were assessed before and six months after surgery. Based on the results of neuropsychological examinations six months after the surgery, the subjects were divided into those with and those without cognitive decline...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#5
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28364452/insomnia-patients-with-objective-short-sleep-duration-have-a-blunted-response-to-cognitive-behavioral-therapy-for-insomnia
#6
Christina J Bathgate, Jack D Edinger, Andrew D Krystal
Study Objectives: This study examined whether individuals with insomnia and objective short sleep duration <6 h, a subgroup with greater risks of adverse health outcomes, differ in their response to cognitive-behavioral therapy for insomnia (CBT-I) when compared to individuals with insomnia and normal sleep duration ≥6 h. Methods: Secondary analyses of a randomized, clinical trial with 60 adult participants (n = 31 women) from a single academic medical center...
January 1, 2017: Sleep
https://www.readbyqxmd.com/read/28317003/peri-operative-inflammatory-cytokines-in-plasma-of-the-elderly-correlate-in-prospective-study-with-postoperative-changes-in-cognitive-test-scores
#7
R Kline, E Wong, M Haile, S Didehvar, S Farber, A Sacks, E Pirraglia, M J de Leon, A Bekker
Increasingly, postoperative cognitive dysfunction (POCD) is recognized as a complication after surgery in the elderly; but it's etiology remains unclear. Here we examine changes in cytokine levels during both the pre-operative and postoperative period, comparing them with long term variation in cognitive test scores. Forty-one patients aged 65 and older undergoing major surgery with general anesthesia were recruited after written consent in this IRB approved study. Thirty went on to complete this prospective, non-interven-tional and non-randomized study...
August 2016: International Journal of Anesthesiology & Research
https://www.readbyqxmd.com/read/27938482/repetitive-and-prolonged-omega-3-fatty-acid-treatment-after-traumatic-brain-injury-enhances-long-term-tissue-restoration-and-cognitive-recovery
#8
Hongjian Pu, Xiaoyan Jiang, Zhishuo Wei, Dandan Hong, Sulaiman Hassan, Wenting Zhang, Jialin Liu, Hengxing Meng, Yejie Shi, Ling Chen, Jun Chen
Traumatic brain injury (TBI) is one of the most disabling clinical conditions that could lead to neurocognitive disorders in survivors. Our group and others previously reported that prophylactic enrichment of dietary omega-3 polyunsaturated fatty acids (n-3 PUFAs) markedly ameliorate cognitive deficits after TBI. However, it remains unclear whether a clinically relevant therapeutic regimen with n-3 PUFAs administered after TBI would still offer significant improvement of long-term cognitive recovery. In the present study, we employed the decline of spatial cognitive function as a main outcome after TBI to investigate the therapeutic efficacy of post-TBI n-3 PUFA treatment and the underlying mechanisms...
April 13, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/27909472/a-patient-with-asymptomatic-cerebral-lesions-during-af-ablation-how-much-should-we-worry
#9
REVIEW
Giovanni B Forleo, Domenico G Della Rocca, Carlo Lavalle, Massimo Mantica, Lida P Papavasileiou, Valentina Ribatti, Germana Panattoni, Luca Santini, Andrea Natale, Luigi Di Biase
Silent brain lesions due to thrombogenicity of the procedure represent recognized side effects of atrial fibrillation (AF) catheter ablation. Embolic risk is higher if anticoagulation is inadequate and recent studies suggest that uninterrupted anticoagulation, ACT levels above 300 seconds and administration of a pre-transeptal bolus of heparin might significantly reduce the incidence of silent cerebral ischemia (SCI) to 2%. Asymptomatic new lesions during AF ablation should suggest worse neuropsychological outcome as a result of the association between silent cerebral infarcts and increased long-term risk of dementia in non-ablated AF patients...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27852196/appropriate-care-for-older-people-with-cognitive-impairment-in-hospital
#10
Gideon A Caplan, Susan E Kurrle, Anne Cumming
More than half of the patients in adult hospitals are over 65 years of age. Although not a normal part of ageing, many older people will present to hospital with cognitive impairment (dementia or delirium) along with other complex comorbidities. Older people, and particularly those with dementia, are also at increased risk of developing delirium during their hospital stay. Delirium has serious short and long term consequences, such as increased mortality, falls, accelerated functional and cognitive decline, and earlier entry to residential care...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27825661/development-and-validation-of-a-mental-practice-tool-for-total-abdominal-hysterectomy
#11
Said S Saab, Jamie Bastek, Sandra Dayaratna, Ellyn Hutton, Catherine R Salva
OBJECTIVE: Total abdominal hysterectomy (TAH) is a common operation performed by obstetrician-gynecologists. Training opportunities for this procedure are declining. Mental practice (MP), the use of mental imagery to rehearse a task symbolically before performance, has been used successfully in sports and music to enhance skill. This strategy demonstrates benefit in existing surgical education literature. We aimed to develop and validate a MP tool (MPT) for resident training in TAH. DESIGN: A prospective survey study was performed in a large, urban, academic medical center in Philadelphia, Pennsylvania, USA...
November 4, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27634796/insomnia-patients-with-objective-short-sleep-duration-have-a-blunted-response-to-cognitive-behavioral-therapy-for-insomnia
#12
Christina J Bathgate, Jack D Edinger, Andrew D Krystal
STUDY OBJECTIVES: This study examined whether individuals with insomnia and objective short sleep duration <6h, a subgroup with greater risks of adverse health outcomes, differ in their response to cognitive behavioral therapy for insomnia (CBT-I) when compared to individuals with insomnia and normal sleep duration >6h. METHODS: Secondary analyses of a randomized, clinical trial with 60 adults participants (n=31 women) from a single academic medical center...
September 9, 2016: Sleep
https://www.readbyqxmd.com/read/27319369/prevalence-of-positive-screening-test-for-cognitive-impairment-among-elderly-urogynecologic-patients
#13
Elisa R Trowbridge, Dahea Kim, Kathryn Barletta, Victoria Fitz, Sarah Larkin, Kathie L Hullfish
BACKGROUND: Impaired cognition has been correlated with adverse postoperative outcomes, such as an increased incidence of delirium, a longer length of hospital stay, and higher 6 month mortality. The incidence of cognitive impairment in the elderly is high. Per the Centers for Disease Control and Prevention, 1 in 8 adults aged 60 years and older deal with memory loss and confusion, and less than 20% inform their health care providers. Most studies in the elderly or cognitively impaired have been conducted at Veterans Administration hospitals, in which the majority of patients are male...
November 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27270150/-unilateral-posterior-reversible-encephalopathy-syndrome-after-ventriculo-peritoneal-shunt-for-normal-pressure-hydrocephalus-following-subarachnoid-hemorrhage-a-case-report
#14
Hiroyuki Sato, Takayuki Koizumi, Daisuke Sato, Shin Endo, Syunichi Kato
The patient, a 79-year-old man, experienced a Hunt & Kosnik grade IV subarachnoid hemorrhage, presenting with sudden-onset coma and severe left hemiplegia. We performed cranial clipping surgery for a ruptured aneurysm on the right middle cerebral artery the same day. Post-operative recovery proceeded smoothly, with gradual improvements in disturbed consciousness and left hemiplegia. Three weeks post-operation, CT revealed low-density areas in the right frontal and temporal lobe, believed to be due to subarachnoid hemorrhage, as well as hydrocephaly...
June 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27145889/pre-existing-cognitive-impairment-and-post-operative-cognitive-dysfunction-should-we-be-talking-the-same-language
#15
Lisbeth Evered, Brendan Silbert, David A Scott
Changes in cognition are known to follow anesthesia and surgery in older individuals (Evered et al., 2011). Although survival per se was the prime outcome in the 19th and early 20th centuries for invasive procedures, a link was none-the-less observed with adverse cognitive outcomes as far back as 1887 (Savage, 1887). Historical reports of "insanity" or "weak mindedness" after anesthesia appeared within 40 years of the first anesthetic having been administered and anecdotal and retrospective reports have implicated anesthesia ever since...
July 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27116905/a-novel-anesthetic-technique-for-pevar
#16
Stuart A Harlin, Ruth A Grissom, Christopher LeCroy, Susan M Pouliot, Scott A Harlin
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) continues to evolve. Device profiles continue to decline, further reducing the physiological insult of the procedure. Anesthesia, however, has not evolved with a large proportion of patients continuing to receive general anesthesia for their increasingly less invasive procedures. We report on a novel anesthetic technique providing outstanding anesthesia in patients undergoing PEVAR in an outpatient setting. The total anesthesia used was remarkably cost effective...
July 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27047716/a-feasibility-study-exploring-the-role-of-pre-operative-assessment-when-examining-the-mechanism-of-chemo-brain-in-breast-cancer-patients
#17
Valerie Jenkins, Ryan Thwaites, Mara Cercignani, Sandra Sacre, Neil Harrison, Hefina Whiteley-Jones, Lisa Mullen, Giselle Chamberlain, Kevin Davies, Charles Zammit, Lucy Matthews, Helena Harder
BACKGROUND: Women receiving chemotherapy treatment for breast cancer may experience problems with their memory and attention (cognition), which is distressing and interferes with quality of life. It is unclear what causes or contributes to the problems they report: psychological distress, fatigue, coping style, or specific biological changes for example to pro inflammatory cytokines. Research shows however, that approximately a third of women with breast cancer perform poorly on tests of cognition before commencing chemotherapy...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27028955/brain-structural-connectivity-distinguishes-patients-at-risk-for-cognitive-decline-after-carotid-interventions
#18
Salil Soman, Gautam Prasad, Elizabeth Hitchner, Payam Massaband, Michael E Moseley, Wei Zhou, Allyson C Rosen
While brain connectivity analyses have been demonstrated to identify ill patients for a number of diseases, their ability to predict cognitive impairment after brain injury is not well established. Traditional post brain injury models, such as stroke, are limited for this evaluation because pre-injury brain connectivity patterns are infrequently available. Patients with severe carotid stenosis, in contrast, often undergo non-emergent revascularization surgery, allowing the collection of pre and post-operative imaging, may experience brain insult due to perioperative thrombotic/embolic infarcts or hypoperfusion, and can suffer post-operative cognitive decline...
June 2016: Human Brain Mapping
https://www.readbyqxmd.com/read/27027720/post-operative-cognitive-dysfunction-at-3-months-in-adults-after-non-cardiac-surgery-a-qualitative-systematic-review
#19
REVIEW
S Paredes, L Cortínez, V Contreras, B Silbert
BACKGROUND: Post-operative cognitive dysfunction is defined as a decline in cognitive functions that occurs after surgery, but different diagnostic criteria and incidences have been reported in medical literature. Our aim was to determine incidence of post-operative cognitive dysfunction 3 months after non-cardiac surgery in adults. METHODS: A systematic review of available evidence was performed by PRISMA guidelines. A search was done in May-July 2015 on PubMed, EMBASE, CINAHL, LILACS, Scielo, Clinical Trials, and Grey Literature Reports...
September 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26780781/rasmussen-s-encephalitis-advances-in-management-and-patient-outcomes
#20
Caitlin E Hoffman, Ayako Ochi, Orlando Carter Snead, Elysa Widjaja, Cynthia Hawkins, Martin Tisdal, James T Rutka
PURPOSE: Rasmussen's encephalitis (RE) is a hemispheric inflammatory disorder resulting in progressive epilepsy, hemiparesis, and cognitive decline. Controversy surrounds the most effective timing of surgery with respect to language dominance, functional status, and seizure outcome. We describe our experience with RE to inform treatment decisions. METHODS: A retrospective chart review was performed in children diagnosed with RE from 1983 to 2012. RESULTS: Thirteen consecutive cases were identified: six males and seven females with a mean age of 10...
April 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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