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Post operative cognitive decline

Hongjian Pu, Xiaoyan Jiang, Zhishuo Wei, Dandan Hong, Sulaiman Hassan, Wenting Zhang, 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 ameliorates 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...
24, 2016: Cell Transplantation
Giovanni B Forleo Md PhD, Domenico G Della Rocca Md, Carlo Lavalle Md, Massimo Mantica Md, Lida P Papavasileiou Md, Valentina Ribatti Md, Germana Panattoni Md, Luca Santini Md PhD, Andrea Natale Md PhD, Luigi Di Biase Md PhD
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
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
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
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
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...
June 16, 2016: American Journal of Obstetrics and Gynecology
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
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
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
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
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
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
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
Catherine C Price, Shellie-Anne Levy, Jared Tanner, Cyndi Garvan, Jade Ward, Farheen Akbar, Dawn Bowers, Mark Rice, Michael Okun
BACKGROUND: Post-operative cognitive dysfunction (POCD) demarks cognitive decline after major surgery but has been studied to date in "healthy" adults. Although individuals with neurodegenerative disorders such as Parkinson's disease (PD) commonly undergo elective surgery, these individuals have yet to be prospectively followed despite hypotheses of increased POCD risk. OBJECTIVE: To conduct a pilot study examining cognitive change pre-post elective orthopedic surgery for PD relative to surgery and non-surgery peers...
2015: Journal of Parkinson's Disease
A Wiedemann, R Maykan, J Pennekamp, H Heppner
OBJECTIVE: Detection of changes in cognition after transurethral resection (TURP) or 180-Watt green-light XPS laser treatment (GLL) of the prostate is required by the German "Krankenhausbedarfsplan" which demands an interdisciplinary dialogue including special aspects of the operating discipline. This has as yet not been investigated in Germany or in Europe. METHODS: Assessments of the cognitive capacity were made by application of the "Mini Mental State Examination" and the "Uhrentest" preoperatively and on postoperative day 2 in addition to documentation of clinical parameters such as patient age, prostate size, duration of surgery, comorbidities, co-medication, changes in haemoglobin and sodium...
February 2016: Aktuelle Urologie
Hiroko H Dodge, Jian Zhu, Nora Mattek, Molly Bowman, Oscar Ybarra, Katherine Wild, David A Loewenstein, Jeffrey A Kaye
INTRODUCTION: Increasing social interaction could be a promising intervention for improving cognitive function. We examined the feasibility of a randomized controlled trial to assess whether conversation-based cognitive stimulation, through personal computers, webcams, and a user-friendly interactive Internet interface had high adherence and a positive effect on cognitive functions among older adults without dementia. METHODS: Daily 30 minute face-to-face communications were conducted over a 6-week trial period in the intervention group...
May 2015: Alzheimer's & Dementia: Translational Research & Clinical Interventions
P J Thompson, S A Baxendale, A W McEvoy, J S Duncan
PURPOSE: To examine the cognitive risks of temporal lobe surgery in patients aged 50 years and older. METHODS: We analysed data from 55 patients who underwent temporal lobe surgery (26 left-sided:29 right sided) from 1988 to 2012 at our centre. Pre-surgical and one year post-operative memory and naming capacity were compared to data obtained from two younger cohorts; 185 aged 18-30 and 220 aged 31-49. RESULTS: Pre-operative memory impairments were most marked for the oldest cohort and were associated with a longer duration of epilepsy...
July 2015: Seizure: the Journal of the British Epilepsy Association
Emma M L Chung, Caroline Banahan, Nikil Patel, Justyna Janus, David Marshall, Mark A Horsfield, Clément Rousseau, Jonathan Keelan, David H Evans, James P Hague
BACKGROUND: Thousands of air bubbles enter the cerebral circulation during cardiac surgery, but whether high numbers of bubbles explain post-operative cognitive decline is currently controversial. This study estimates the size distribution of air bubbles and volume of air entering the cerebral arteries intra-operatively based on analysis of transcranial Doppler ultrasound data. METHODS: Transcranial Doppler ultrasound recordings from ten patients undergoing heart surgery were analysed for the presence of embolic signals...
2015: PloS One
B Ruiz-Núñez, G H A M van den Hurk, J H M de Vries, M A Mariani, M J L de Jongste, D A J Dijck-Brouwer, F A J Muskiet
CHD may ensue from chronic systemic low-grade inflammation. Diet is a modifiable risk factor for both, and its optimisation may reduce post-operative mortality, atrial fibrillation and cognitive decline. In the present study, we investigated the usual dietary intakes of patients undergoing elective coronary artery bypass grafting (CABG), emphasising on food groups and nutrients with putative roles in the inflammatory/anti-inflammatory balance. From November 2012 to April 2013, we approached ninety-three consecutive patients (80% men) undergoing elective CABG...
May 14, 2015: British Journal of Nutrition
Lazzaro Repetto, Andrea Luciani
In 2020 the percentage of patients with a diagnosis of cancer in people with more than 65 years will exceed 70% and 28% in ethnic minorities. The treatment of cancer in these populations is challenging for the oncologists due to socio-economic issues such as poverty, reduced access to the hospital care, level of education. The clinical pathway "diagnosis-treatment-cure", typical of the care of young patients has to be integrated in elderly patients with a more individualized treatment by means of comprehensive geriatric assessment (CGA)...
January 2015: Recenti Progressi in Medicina
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