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postoperative cognitive dysfunction

Susana Vacas, Vincent Degos, Mervyn Maze
BACKGROUND: Sleep is integral to biologic function, and sleep disruption can result in both physiological and psychologic dysfunction including cognitive decline. Surgery activates the innate immune system, inducing neuroinflammatory changes that interfere with cognition. Because surgical patients with sleep disorders have an increased likelihood of exhibiting postoperative delirium, an acute form of cognitive decline, we investigated the contribution of perioperative sleep fragmentation (SF) to the neuroinflammatory and cognitive responses of surgery...
October 11, 2016: Anesthesia and Analgesia
Ashok Kumar Saxena, Geetanjali T Chilkoti, Anand K Chopra, Basu Dev Banerjee, Tusha Sharma
BACKGROUND: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. METHODS: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included...
October 2016: Korean Journal of Pain
M M Petrova, S V Prokopenko, O V Eremina, E Yu Mozheiko, D S Kaskaeva
AIM: To evaluate the efficacy of computer-based stimulation programs in the correction of postoperative cognitive dysfunction in patients with ischemic heart disease in remote period after coronary artery bypass surgery. MATERIAL AND METHODS: The study involved 74 patients. All patients underwent a drug therapy and the rehabilitation course using computer-based stimulation programs (1 time per day for 20 minutes during10 days). Coronary artery bypass surgery was performed for all patients...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Yuping Li, Ke Pan, Lin Chen, Jiao-Lin Ning, Xiaojun Li, Ting Yang, Niccolò Terrando, Jianteng Gu, Guocai Tao
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a common complication after surgery, especially amongst elderly patients. Neuroinflammation and iron homeostasis are key hallmarks of several neurological disorders. In this study, we investigated the role of deferoxamine (DFO), a clinically used iron chelator, in a mouse model of surgery-induced cognitive dysfunction and assessed its neuroprotective effects on neuroinflammation, oxidative stress, and memory function. METHODS: A model of laparotomy under general anesthesia and analgesia was used to study POCD...
October 12, 2016: Journal of Neuroinflammation
Atsushi Sekiguchi, Chiho Sato, Izumi Matsudaira, Yuka Kotozaki, Rui Nouchi, Hikaru Takeuchi, Masaaki Kawai, Hiroshi Tada, Takanori Ishida, Yasuyuki Taki, Noriaki Ohuchi, Ryuta Kawashima
Cancer survivors are exposed to several risk factors for cognitive dysfunction, such as general anesthesia, surgical trauma, and adjuvant therapies. In our recent study we showed that thalamic volume reduction and attentional dysfunction occurred shortly after surgery. Here, we examined the 6-month prognosis of the 20 patients with breast cancer who underwent surgery. Seven patients did not receive any adjuvant therapy after the surgery and 13 patients received a hormonal therapy after the surgery. We assessed their attentional functions, and thalamic volumes shortly after and 6 months after surgery...
October 6, 2016: Scientific Reports
J E Scott, J L Mathias, A C Kneebone, J Krishnan
Whether total joint replacement (TJR) patients are susceptible to postoperative cognitive dysfunction (POCD) remains unclear due to inconsistencies in research methodologies. Moreover, cognitive reserve may moderate the development of POCD after TJR, but has not been investigated in this context. The current study investigated POCD after TJR, and its relationship with cognitive reserve, using a more rigorous methodology than has previously been utilized. Fifty-three older adults (aged 50+) scheduled for TJR were assessed pre and post surgery (6 months)...
September 27, 2016: Journal of Clinical and Experimental Neuropsychology
Fa-Ping Tu, Jun-Xiang Li, Qiang Li, Ji Wang
BACKGROUND: Hepatic ischemia/reperfusion (hepatic I/R) has been found to induce cognitive dysfunction. The NR2B subunit of N-methyl-D-aspartate (NMDA) receptors is a major factor in memory and learning processes, and hydrogen sulfide (H2S) may modulate this NMDA receptor. Therefore, in this study, sodium hydrosulfide (NaHS, a donor of H2S) was administered in an animal model of hepatic I/R to investigate the effects of H2S on cognitive impairment and expression of NR2B. MATERIALS AND METHODS: NaHS (5 mg/kg) or normal saline was administered intraperitoneally once a day for 11 consecutive days, during which a rat model of 70% hepatic I/R was established on the fourth day...
October 2016: Journal of Surgical Research
Fernanda Herrera da Costa, Paulo Adilson Herrera, Cecília Luiz Pereira-Stabile, Glaykon Alex Vitti Stabile
Delirium is an organic mental syndrome with acute onset characterized by diffuse brain dysfunction and neural activity disorganization. It is usually related to cognition and perception changes, decreased level of consciousness, and disorganization of thoughts that are unrelated to previous dementia. Occurrence is more frequent in patients with previous degenerative disease and elderly patients, especially those older than 85 years. Although the pathophysiology is not totally known, studies have shown that, among the main factors that lead to delirium, the drugs used for general anesthesia induction are the most relevant (hypnotics, anticholinergic drugs, and H2 receptor blockers), especially those used in long surgical procedures...
August 27, 2016: Journal of Oral and Maxillofacial Surgery
Nakao Ota, Felix Goehre, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Humihiro Sakakibara, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada, Rokuya Tanikawa
BACKGROUND: The application of bypass procedures to the posterior cerebral artery (PCA) in combination with proximal clipping or trapping is a useful option for the treatment of complex posterior circulation aneurysms, especially those of the PCA. Due to its course around the midbrain through various cisterns, different approaches are required to access the PCA. OBJECTIVE: The presented study analyzes a retrospective case series of bypass procedures to the PCA to investigate the relevant treatment strategies and their outcomes...
September 16, 2016: World Neurosurgery
Santiago Hem, Romina Albite, Monica Loresi, Jorge Rasmussen, Pablo Ajler, Claudio Yampolsky, Joseph D Chabot, Peter C Gerszten, Ezequiel Goldschmidt
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a known complication after intracranial surgery. Impaired hippocampal neurogenesis has been associated with cognitive dysfunction in animal models. METHODS: In order to assess hippocampal changes after brain surgery, a frontal lobe corticectomy was performed in ten adult Wistar rats (group 4). Three different control groups (n = 10 each) included no treatment (G1), general anesthesia alone (G2), and craniectomy without dural opening (G3)...
November 2016: Acta Neurochirurgica
Ke Pan, Xiaojun Li, Yan Chen, Dan Zhu, Yuping Li, Guocai Tao, Zhiyi Zuo
Postoperative cognitive dysfunction (POCD) is a common complication of elderly patients after surgery. The mechanisms of POCD have not been clarified. Iron accumulation is a feature of neurodegeneration. Recent reports showed that iron content was increased with impaired cognition induced by surgery. We sought to investigate whether iron chelation would attenuate POCD. In this study, male aged (18 months) Sprague-Dawley rats received 100 mg/kg deferoxamine or saline solution (0.9%) for 6 days before exploratory laparotomy...
December 2016: Neuropharmacology
N A Smith, Y Y Yeow
Postoperative cognitive disorders are common in elderly patients. Pre-existing cognitive impairment including mild cognitive impairment may be an important risk factor for developing postoperative cognitive dysfunction and may not be detected in a standard preoperative interview, yet is not routinely sought. Our primary aim was to estimate the prevalence of mild cognitive impairment among elderly patients presenting to our hospital for elective surgery using a simple established screening tool: the Montreal Cognitive Assessment test...
September 2016: Anaesthesia and Intensive Care
Jae Lim Kim, Ji Sun Jung, Sang Jun Kim
OBJECTIVE: To predict ambulatory capacity, 1 month after physical therapy following hip fracture surgery. METHODS: A retrospective chart review was carried out. Patients more than 60 years old, who underwent hip fracture surgery and received physical therapies, were selected (n=548). Age, gender, presence of cognitive dysfunction, combined medical diseases, combined fractures, previous history of hip surgery, prefracture ambulatory capacity, days from the fracture to surgery, type of fracture, type of surgery, presence of postoperative complications, days from the surgery to physical therapy, and total admission period, were collected...
August 2016: Annals of Rehabilitation Medicine
Yan Wang, Xiaohua Liu, Haiying Li
OBJECTIVE: To explore the effect of general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia on the incidence of the post-operative cognitive dysfunction (POCD) in elderly patients.
 METHODS: A total of 100 elderly patients with gastric cancer, who underwent radical gastrectomy in Yan'an People's Hospital from March 2012 to March 2015, were randomly divided into 3 groups: a general anesthesia and patient-controlled intravenous analgesia (PCIA) (Group I, n=35), a general anesthesia combined with epidural anesthesia and PCIA (Group II, n=30), and a general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia (PCEA) (Group III, n=35)...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Wenzhen Shen, Keliang Lu, Jiawan Wang, Anshi Wu, Yun Yue
Postoperative cognitive dysfunction (POCD) is a serious complication following surgery, however, the mechanism of POCD remains to be elucidated. Previous evidence has revealed that POCD may be associated with the pathogenesis of neurodegenerative processes. The mammalian target of rapamycin (mTOR) signaling pathway has been reported to be crucial in the pathophysiology of neurodegenerative diseases. However, the implications of mTOR in POCD remains to be fully elucidated. In the present study, western blotting and enzyme‑linked immunosorbent assay were used to determine the expression of mTOR and any associated downstream targets; contextual fear conditioning was used to estimate the learning and memory ability of mice...
October 2016: Molecular Medicine Reports
Zheng-Tao Lv, Jun-Ming Huang, Jin-Ming Zhang, Jia-Ming Zhang, Jin-Feng Guo, An-Min Chen
Background. Ulinastatin, identified as a urinary trypsin inhibitor, has been widely used in patients with inflammatory disorders. However, little is known about its effect on postoperative cognitive dysfunction (POCD). The aim of our current work is to review the current body of literature. Methods. A systematic literature search in PubMed and EMBASE was performed to identify randomized controlled trials. Incidence of POCD, MMSE score, and laboratory indicators (IL-6, TNF-α, CRP, and S100β) were selected as outcomes...
2016: BioMed Research International
Ulku Emik, Yusuf Unal, Mustafa Arslan, Cengiz Bekir Demirel
OBJECTIVES: Postoperative cognitive dysfunction refers to the problems associated with thought and memory that are often experienced after major surgery. The aim of this study is to evaluate the effects of intraperitoneally administered memantine on recovery, cognitive functions, and pain after propofol anesthesia. METHODS: The study was conducted in Gazi University Animal Research Laboratory, Ankara, Turkey in January 2012. Twenty-four adult female Wistar Albino rats weighing 170-270g were educated for 300s in the radial arm maze (RAM) over three days...
September 2016: Brazilian Journal of Anesthesiology
Ekawut Chankaew, Prajak Srirabheebhat, Sriwimon Manochiopinig, Theerapol Witthiwej, Itsara Benjamin
OBJECTIVE Normal pressure hydrocephalus (NPH) is clinically characterized by gait disturbance, cognitive impairment, and urinary incontinence, as well as enlargement of the ventricles. To the best of the authors' knowledge, there have been no previous publications regarding the correlation between bulbar dysfunction and NPH. The primary objective of this study was to compare preoperative and postoperative prevalence of bulbar dysfunction in patients with NPH. Secondary objectives included assessing the results of surgery for swallowing, speech, gait, cognition, and urination, and evaluating the correlation between bulbar dysfunction and triad symptoms...
September 2016: Neurosurgical Focus
M Franck, K Nerlich, B Neuner, P Schlattmann, W R Brockhaus, C D Spies, F M Radtke
BACKGROUND: Post-operative delirium and post-operative cognitive dysfunction (POCD) are both common but it has not been clarified how closely they are associated. We aimed to assess the possible relationship in a secondary analysis of data from the 'Surgery Depth of anaesthesia and Cognitive outcome'- study. METHODS: We included patients aged ≥ 60 years undergoing non-cardiac surgery planned for longer than 60 min. Delirium was assessed according to the Diagnostic and Statistical Manual of Mental Disorders IV criteria in the post-anaesthesia care unit (PACU) as well as within the first week after surgery...
November 2016: Acta Anaesthesiologica Scandinavica
Jan Hirsch, Susana Vacas, Niccolo Terrando, Miao Yuan, Laura P Sands, Joel Kramer, Kevin Bozic, Mervyn M Maze, Jacqueline M Leung
BACKGROUND: Postoperative delirium is prevalent in older patients and associated with worse outcomes. Recent data in animal studies demonstrate increases in inflammatory markers in plasma and cerebrospinal fluid (CSF) even after aseptic surgery, suggesting that inflammation of the central nervous system may be part of the pathogenesis of postoperative cognitive changes. We investigated the hypothesis that neuroinflammation was an important cause for postoperative delirium and cognitive dysfunction after major non-cardiac surgery...
2016: Journal of Neuroinflammation
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