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postoperative cognitive dysfunction

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https://www.readbyqxmd.com/read/29784501/consequences-of-quality-of-reduction-on-osteosynthesis-complications-and-quality-of-life-in-elderly-patients-with-subtrochanteric-fracture
#1
P Codesido-Vilar, A Mejía-Casado, J Riego-Fernández, N Rodriguez-Casas, S García-Cabanas, J Rivas-Felice, L García-Quevedo
OBJECTIVE: To compare results in terms of orthopaedic complications and quality of life in elderly patients with subtrochanteric fracture treated with intramedullary nailing according to fracture reduction status. PATIENTS AND METHODS: A prospective cohort study including 90 elderly patients with subtrochanteric fractures of the femur treated with a cephalomedullary nail, with a minimum 1-year follow up. The inclusion criteria were: aged 60 years or older, without severe cognitive dysfunction and independent ambulatory capability before the fracture...
May 18, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29782389/development-of-a-novel-self-administered-cognitive-assessment-tool-and-normative-data-for-older-adults
#2
Raphael J Monsch, Amélie C Burckhardt, Manfred Berres, Alessandra E Thomann, Michael M Ehrensperger, Luzius A Steiner, Nicolai Goettel
BACKGROUND: Preexisting cognitive impairment in surgical patients is one of the leading risk factors for adverse cognitive outcomes such as postoperative delirium and postoperative cognitive dysfunction. We developed a self-administered tablet computer application intended to assess the individual risk for adverse postoperative cognitive outcomes. This cross-sectional study aimed to establish normative data for the tool. MATERIALS AND METHODS: Healthy volunteers aged 65 years and above were administered the Mini-Mental State Examination, Geriatric Depression Scale, and Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological Assessment Battery to assess cognitive health...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29776428/evidence-of-the-impact-of-systemic-inflammation-on-neuroinflammation-from-a-non-bacterial-endotoxin-animal-model
#3
Chunxia Huang, Michael Garnet Irwin, Gordon Tin Chun Wong, Raymond Chuen Chung Chang
BACKGROUND: Systemic inflammation induces neuroinflammation and cellular changes such as tau phosphorylation to impair cognitive function, including learning and memory. This study uses a single model, laparotomy without any pathogen, to characterize these changes and their responses to anti-inflammatory treatment in the intermediate term. METHODS: In a two-part experiment, wild-type C57BL/6N mice (male, 3 month old, 25 ± 2 g) were subjected to sevoflurane anesthesia alone or to a laparotomy...
May 17, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29772594/-upper-age-limit-in-outpatient-anesthesia-opportunities-and-risks
#4
Tobias Hüppe, Nicole Kneller, Alexander Raddatz
Ambulatory surgery in elderly patients continues to increase - avoiding hospitalization and thus postoperative cognitive dysfunction in older patients being its major objectives. An upper age limit in outpatient anesthesia does not exist to date. However, functional rather than chronological age is crucial in patient selection. In consensus discussion, baseline functional status should be evaluated regularly - defined as everyday behaviors necessary to maintain daily life and encompassing areas of physical, cognitive, and social functioning...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29771439/remifentanil-on-t-lymphocytes-cognitive-function-and-inflammatory-cytokines-of-patients-undergoing-radical-surgery-for-cervical-cancer
#5
X-Y Lu, M Chen, D-H Chen, Y Li, P-T Liu, Y Liu
OBJECTIVE: To explore the effects of remifentanil on cognitive function, T lymphocyte subsets and inflammatory cytokines of patients undergoing radical surgery for cervical cancer. PATIENTS AND METHODS: A total of 70 patients undergoing radical surgery for cervical cancer in our hospital from August 2014 to January 2017 were selected. They were divided into control group (n=35) and experimental group (n=35). The patients in the control group received intravenous drip of fentanyl, while those in the experimental group received intravenous drip of remifentanil in the surgery...
May 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29761891/processed-electroencephalogram-and-evoked-potential-techniques-for-amelioration-of-postoperative-delirium-and-cognitive-dysfunction-following-non-cardiac-and-non-neurosurgical-procedures-in-adults
#6
REVIEW
Yodying Punjasawadwong, Waraporn Chau-In, Malinee Laopaiboon, Sirivimol Punjasawadwong, Pathomporn Pin-On
BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through optimization of anaesthetic doses. OBJECTIVES: To assess whether the use of processed EEG or auditory evoked potential (AEP) indices (bispectral index (BIS), narcotrend index, cerebral state index, state entropy and response entropy, patient state index, index of consciousness, A-line autoregressive index, and auditory evoked potentials (AEP index)) as guides to anaesthetic delivery can reduce the risk of POD and POCD in non-cardiac surgical or non-neurosurgical adult patients undergoing general anaesthesia compared with standard practice where only clinical signs are used...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29761010/central-cholinergic-system-mediates-working-memory-deficit-induced-by-anesthesia-surgery-in-adult-mice
#7
Xiao Zhang, Xuliang Jiang, Lili Huang, Weitian Tian, Xuemei Chen, Xiyao Gu, Weifeng Yu, Jie Tian, Diansan Su
Background: Postoperative cognitive dysfunction (POCD) is consistently associated with increased morbidity and mortality, which has become a major concern of patients and caregivers. Although POCD occurs mainly in aged patients, it happens at any age. Previous studies demonstrated that anesthesia/surgery had no effects on reference memory of adult mice. However, whether it impairs working memory remains unclear. Working memory deficit would result in many deficits of executive function...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29756691/cerebrovascular-autoregulation-impairments-during-cardiac-surgery-with-cardiopulmonary-bypass-are-related-to-postoperative-cognitive-deterioration-prospective-observational-study
#8
Birute Kumpaitiene, Milda Svagzdiene, Edmundas Sirvinskas, Virginija Adomaitiene, Vytautas Petkus, Rolandas Zakelis, Solventa Krakauskaite, Romanas Chomskis, Arminas Ragauskas, Teodoro F Dagi, Rimantas Benetis
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient- specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754693/preoperative-6-minute-walk-distance-is-associated-with-postoperative-cognitive-dysfunction
#9
Kazuhiro Hayashi, Hideki Oshima, Miho Shimizu, Kiyonori Kobayashi, Shigeyuki Matsui, Yoshihiro Nishida, Akihiko Usui
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation...
April 25, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29743884/exploring-postoperative-cognitive-dysfunction-and-delirium-in-noncardiac-surgery-using-mri-a-systematic-review
#10
REVIEW
Chenxi Huang, Johan Mårtensson, Ismail Gögenur, Mohammad Sohail Asghar
Surgical patients are at high risk of developing postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). POCD and POD are associated with increased morbidity and mortality and worsening functional outcomes leading to severe socioeconomic consequences for the patient and the society in general. Magnetic resonance imaging (MRI) offers a unique opportunity to study the anatomy and function of the brain. MRI thus plays an important role in elucidating the neuronal component of POCD and POD...
2018: Neural Plasticity
https://www.readbyqxmd.com/read/29743866/dexmedetomidine-inhibits-inflammation-in-microglia-cells-under-stimulation-of-lps-and-atp-by-c-fos-nlrp3-caspase-1-cascades
#11
Hu Li, Xueping Zhang, Mingfu Chen, Jianyan Chen, Tao Gao, Shanglong Yao
NOD-like receptor 3 (NLRP3) plays critical roles in the initiation of inflammasome-mediated inflammation in microglia, thus becomes an important therapeutic target of Alzheimer's disease (AD). Dexmedetomidine (Dex), a new type of clinical anesthetic agent, shows anti-inflammatory properties and inhibits postoperative cognitive dysfunction in AD patients. The present study was aimed to investigate effect of Dex on NLRP3 activity in activated microglia and reveal the underlying mechanisms. The human microglia clone 3 (HMC3) cells were exposed to 100 ng/ml LPS and 5 mM ATP, in the presence and absence of doses of Dex...
2018: EXCLI Journal
https://www.readbyqxmd.com/read/29725829/involvement-of-acute-neuroinflammation-in-postoperative-delirium-like-cognitive-deficits-in-rats
#12
Takashi Kawano, Daiki Yamanaka, Bun Aoyama, Hiroki Tateiwa, Marie Shigematsu-Locatelli, Atsushi Nishigaki, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
PURPOSE: The purpose of this study was to investigate the age-, time-, and brain region-dependent postoperative neuroinflammatory trajectory, and its association with neurocognitive outcomes in rats. METHODS: Adult and aged rats were randomly assigned to one of three groups: control, isoflurane anesthesia alone, and isoflurane anesthesia with abdominal surgery. On either postoperative day 2 (early phase) or 7 (late phase), all rats were tested for trace and context fear memory retention after acquisition of trace fear conditioning...
May 3, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29678977/minimizing-icu-neurological-dysfunction-with-dexmedetomidine-induced-sleep-mindds-protocol-for-a-randomised-double-blind-parallel-arm-placebo-controlled-trial
#13
Kenneth T Shelton, Jason Qu, Federico Bilotta, Emery N Brown, Gaston Cudemus, David A D'Alessandro, Hao Deng, Alan DiBiasio, Jacob A Gitlin, Eunice Y Hahm, Lauren E Hobbs, Timothy T Houle, Reine Ibala, Marco Loggia, Kara J Pavone, Shahzad Shaefi, George Tolis, M Brandon Westover, Oluwaseun Akeju
INTRODUCTION: Delirium, which is prevalent in postcardiac surgical patients, is an acute brain dysfunction characterised by disturbances in attention, awareness and cognition not explained by a pre-existing neurocognitive disorder. The pathophysiology of delirium remains poorly understood. However, basic science and clinical studies suggest that sleep disturbance may be a modifiable risk factor for the development of delirium. Dexmedetomidine is a α-2A adrenergic receptor agonist medication that patterns the activity of various arousal nuclei similar to sleep...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678619/effect-of-goal-directed-fluid-therapy-on-early-cognitive-function-in-elderly-patients-with-spinal-stenosis
#14
Na Zhang, Min Liang, Dan-Dan Zhang, Yi-Rong Xiao, Yan-Zhen Li, You-Guang Gao, Hong-da Cai, Xian-Zhong Lin, Cai-Zhu Lin, Kai Zeng, Xiao-Dan Wu
PURPOSE: To explore effect of goal-directed fluid therapy (GDFT) on early cognitive function in elderly patients with spinal stenosis. METHODS: 83 elderly patients with spinal stenosis were randomly classified into two groups: control group (n = 40) and GDFT group (n = 43). The Montreal Cognitive Assessment (MoCA) score, IL-6 and S100β levels, hemodynamic parameters, cerebral oxygen saturation (rSO2 ), arterial lactic acid values, output of surgery, operation time and cases of hypotension, intraoperative complications within 7 days were recorded for all patients...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29678514/effect-of-neoadjuvant-therapy-and-rectal-surgery-on-health-related-quality-of-life-in-patients-with-rectal-cancer-during-the-first-2-years-after-diagnosis
#15
Alice M Couwenberg, Johannes P M Burbach, Wilhelmina M U van Grevenstein, Anke B Smits, Esther C J Consten, Anandi H W Schiphorst, Niels A T Wijffels, Joost T Heikens, Martijn P W Intven, Helena M Verkooijen
INTRODUCTION: Rectal cancer surgery with neoadjuvant therapy is associated with substantial morbidity. The present study describes the course of quality of life (QOL) in rectal cancer patients in the first 2 years after the start of treatment. PATIENTS AND METHODS: We performed a prospective study within a colorectal cancer cohort including rectal cancer patients who were referred for neoadjuvant chemoradiation or short-course radiotherapy and underwent rectal surgery...
March 21, 2018: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29672286/activated-%C3%AE-7nachr-improves-postoperative-cognitive-dysfunction-and-intestinal-injury-induced-by-cardiopulmonary-bypass-in-rats-inhibition-of-the-proinflammatory-response-through-the-th17-immune-response
#16
Keyan Chen, YingJie Sun, Wanwei Dong, Tiezheng Zhang, Nan Zhou, Weiwei Yu, Yugang Diao, Shanbin Guo, Yue Tian
Backgrund/Aims: To investigate the effects of activated α7 nicotinic acetylcholine receptor (α7nAChR) on postoperative cognitive dysfunction (POCD) and intestinal injury induced by cardiopulmonary bypass (CPB) and its relationship with the Th17 response in order to provide a theoretical basis for organ protection and targeted drug therapy during the perioperative period. METHODS: Sprague-Dawley rat models of CPB were established. Rat intestinal and brain injuries were observed after CPB using hematoxylin and eosin staining...
April 16, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29671090/postoperative-cognitive-dysfunction-after-cochlear-implantation
#17
Annes J Claes, Suzanne de Backer, Paul Van de Heyning, Annick Gilles, Vincent Van Rompaey, Griet Mertens
PURPOSE: Postoperative cognitive dysfunction (PCD) is a subtle, prolonged deterioration in cognition after surgery. This complication has been frequently investigated, mainly after major (cardiac) surgery. However, the incidence after cochlear implantation is unknown. Therefore, the aim of the study was to investigate the incidence and possible risk factors of PCD in severely hearing-impaired older adults after cochlear implantation. METHODS: In a prospective cohort study, 26 older participants (age: M = 70, SD = 8 years), scheduled for cochlear implantation, were assessed prior to and 1 week after implantation by means of the Montreal Cognitive Assessment (MoCA)...
April 18, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29670465/emerging-roles-of-immune-cells-in-postoperative-cognitive-dysfunction
#18
REVIEW
Yue Liu, Yiqing Yin
Postoperative cognitive dysfunction (POCD), a long-lasting cognitive decline after surgery, is currently a major clinical problem with no clear pathophysiological mechanism or effective therapy. Accumulating evidence suggests that neuroinflammation plays a critical role in POCD. After surgery, alarmins are leaked from the injury sites and proinflammatory cytokines are increased in the peripheral circulation. Neurons in the hippocampus, which is responsible for learning and memory, can be damaged by cytokines transmitted to the brain parenchyma...
2018: Mediators of Inflammation
https://www.readbyqxmd.com/read/29665808/critical-role-of-nlrp3-caspase-1-pathway-in-age-dependent-isoflurane-induced-microglial-inflammatory-response-and-cognitive-impairment
#19
Zhi Wang, Shiyu Meng, Lin Cao, Ying Chen, Zhiyi Zuo, Shuling Peng
BACKGROUND: Elderly patients are more likely to suffer from postoperative cognitive dysfunction (POCD) after surgery and anesthesia. Except for declined organ function, the particular pathogenesis of POCD in elderly patients remains unknown. This study is carried out to determine the critical role of the NOD-like receptor protein 3 (NLRP3)-caspase-1 pathway in isoflurane-induced cognitive impairment. METHODS: Young (6-8 months old) and aged (14 months old) healthy male C57BL/6 mice were exposed to 1...
April 17, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29661144/pretreatment-with-nimodipine-reduces-incidence-of-pocd-by-decreasing-calcineurin-mediated-hippocampal-neuroapoptosis-in-aged-rats
#20
Qi Zhang, Yanan Li, Yongjuan Bao, Chunping Yin, Xi Xin, Yangyang Guo, Fang Gao, Shuping Huo, Xiuli Wang, Qiujun Wang
BACKGROUND: Calcineurin (CaN) having a high expression in hippocampal neurons is closely related to apoptosis. Pretreatment with nimodipine can lower the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). However, the relationship between cerebral protective effect of pretreatment with nimodipine and CaN is controversial in the literature. The aim of this study is to evaluate the relationship between neuroprotective effect of nimodipine and CaN on POCD in aged rats...
April 16, 2018: BMC Anesthesiology
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