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Pre operative cognitive assessment

Hannah L Radabaugh, Lauren J Carlson, Darik A O'Neil, Megan J LaPorte, Christina M Monaco, Jeffrey P Cheng, Patricia B de la Tremblaye, Naima Lajud, Corina O Bondi, Anthony E Kline
Environmental enrichment (EE) promotes behavioral recovery after experimental traumatic brain injury (TBI). However, the chronic rehabilitation provided in the laboratory is not analogous to the clinic where physiotherapy is typically limited. Moreover, females make up approximately 40% of the clinical TBI population, yet they are seldom studied in brain trauma. Hence, the goal of this study was to test the hypothesis that abbreviated EE would confer neurobehavioral, cognitive, and histological benefits in brain injured female rats...
September 28, 2016: Experimental Neurology
Dennis Hamacher, Margit Rudolf, Christoph Lohmann, Lutz Schega
BACKGROUND: Pain has disruptive effects on cognitive functions leading to a decreased capability to multi task. This might be the reason why pain is a fall risk factor in dual-task situations. This study aims to relate a decrease/increase in pain severity with a decrease/increase in dual-task costs of gait variability, which is associated with fall risk, in patients with osteoarthritis prior to and 6-8weeks after total knee replacement. METHODS: We assessed the variability of minimum toe clearance in normal walking and dual-task walking in 36 patients (14 male and 22 female participants; age=mean 64...
September 22, 2016: Clinical Biomechanics
Raymond R Bond, Dewar D Finlay, James McLaughlin, Daniel Guldenring, Andrew Cairns, Alan Kennedy, Robert Deans, Albert L Waldo, Aaron Peace
INTRODUCTION: The CardioQuick Patch® (CQP) has been developed to assist operators in accurately positioning precordial electrodes during 12-lead electrocardiogram (ECG) acquisition. This study describes the CQP design and assesses the device in comparison to conventional electrode application. METHODS: Twenty ECG technicians were recruited and a total of 60 ECG acquisitions were performed on the same patient model over four phases: (1) all participants applied single electrodes to the patient; (2) all participants were then re-trained on electrode placement and on how to use the CQP; (3) participants were randomly divided into two groups, the standard group applied single electrodes and the CQP group used the CQP; (4) after a one day interval, the same participants returned to carry out the same procedure on the same patient (measuring intra-practitioner variability)...
August 18, 2016: Journal of Electrocardiology
Sara N Goldhaber-Fiebert, Justin Pollock, Steven K Howard, Sylvia Bereknyei Merrell
BACKGROUND: Emergency manuals (EMs), context-relevant sets of cognitive aids or crisis checklists, have been used in high-hazard industries for decades, although this is a nascent field in health care. In the fall of 2012, Stanford clinically implemented EMs, including hanging physical copies in all Stanford operating rooms (ORs) and training OR clinicians on the use of, and rationale for, EMs. Although simulation studies have shown the effectiveness of EMs and similar tools when used by OR teams during crises, there are little data on clinical implementations and uses...
September 2016: Anesthesia and Analgesia
Guang Xu, Lan-Lan Li, Zhen-Tao Sun, Wei Zhang, Xue-Ping Han
BACKGROUND Because of the restricted data available on patients with postoperative cognitive dysfunction (POCD) in orthotopic liver transplantation (OLT), the goal of our study was to determine the outcome of dexmedetomidine (DEX) on POCD and the mechanism operating in OLT patients. MATERIAL AND METHODS Our study included 80 patients randomly divided into 2 equal groups: the DEX group and the control group. In the DEX group, our patients received an initial dose of DEX at 1 µg/kg for 10 min followed by a continuous infusion at 0...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
P Baier, G Ihorst, G Wolff-Vorbeck, M Hüll, U Hopt, B Deschler
AIMS: Comprehensive Geriatric Assessment (CGA) provides information on aspects of older patients to predict risks and benefits of interventions. METHODS: To evaluate the application of CGA (including quality of life (QOL)) for the risk prediction of postoperative dependence and QOL in elderly patients with malignant tumours, a prospective observational study including 200 patients >70 years was performed. The primary outcome was postoperative activities of daily living (ADL < 95), secondary outcome was QOL at 6 months...
July 30, 2016: European Journal of Surgical Oncology
Vugar Nabiyev, Selim Ayhan, Selcen Yuksel, Asli Niyazi, Tiro Mmopelwa, Montse Domingo-Sabat, Alba Vila-Casademunt, Ferran Pellise, Ahmet Alanay, Francisco J Perez-Grueso, Frank Kleinstück, Ibrahim Obeid, Emre Acaroglu, European Spine Study Group
AIM: To analyze the cognitive abilities of older patients undergoing spinal deformity surgery so as to understand whether adult spinal deformity (ASD) surgery is associated with postoperative cognitive malfunction. MATERIAL AND METHODS: A prospective longitudinal study was performed on surgical patients older than 50 years, enrolled in a prospective multicenter database. Mini-mental state examination (MMSE) was performed to assess cognitive function in addition to the HRQOL tests; (SF-36, ODI and SRS-22) at pre-operative, post-operative 6 weeks and 6 months points...
June 24, 2016: Turkish Neurosurgery
Lena Wimmer, Silja Bellingrath, Lisa von Stockhausen
The present paper reports a pilot study which tested cognitive effects of mindfulness practice in a theory-driven approach. Thirty-four fifth graders received either a mindfulness training which was based on the mindfulness-based stress reduction approach (experimental group), a concentration training (active control group), or no treatment (passive control group). Based on the operational definition of mindfulness by Bishop et al. (2004), effects on sustained attention, cognitive flexibility, cognitive inhibition, and data-driven as opposed to schema-based information processing were predicted...
2016: Frontiers in Psychology
Beatrice Latal, Gabriele Wohlrab, Barbara Brotschi, Ingrid Beck, Walter Knirsch, Vera Bernet
OBJECTIVES: To evaluate the predictive value of pre- and postoperative amplitude-integrated electroencephalography (aEEG) on neurodevelopmental outcomes in children operated for congenital heart disease (CHD). STUDY DESIGN: Prospectively enrolled cohort of 60 infants with CHD who underwent cardiac surgery with cardiopulmonary bypass in the first 3 months of life. Infants with a genetic comorbidity were excluded. aEEG was assessed for 12 hours pre- and 48 hours postoperatively...
July 22, 2016: Journal of Pediatrics
Bjørn Erik Neerland, Roanna J Hall, Ingebjørg Seljeflot, Frede Frihagen, Alasdair M J MacLullich, Johan Raeder, Torgeir Bruun Wyller, Leiv Otto Watne
OBJECTIVES: To examine whether delirium in individuals with hip fracture is associated with high C-reactive protein (CRP), interleukin-6 (IL-6), and soluble IL-6 receptor (sIL-6R) levels in the cerebrospinal fluid (CSF). DESIGN: Prospective cohort study. SETTING: Two university hospitals in Oslo, Norway, and Edinburgh, United Kingdom. PARTICIPANTS: Individuals admitted with acute hip fracture (N = 151). MEASUREMENTS: Participants were assessed for delirium pre- and postoperatively using the Confusion Assessment Method...
July 2016: Journal of the American Geriatrics Society
T S Wildes, A C Winter, H R Maybrier, A M Mickle, E J Lenze, S Stark, N Lin, S K Inouye, E M Schmitt, S L McKinnon, M R Muench, M R Murphy, R T Upadhyayula, B A Fritz, K E Escallier, G P Apakama, D A Emmert, T J Graetz, T W Stevens, B J Palanca, R L Hueneke, S Melby, B Torres, J Leung, E Jacobsohn, M S Avidan
INTRODUCTION: Postoperative delirium, arbitrarily defined as occurring within 5 days of surgery, affects up to 50% of patients older than 60 after a major operation. This geriatric syndrome is associated with longer intensive care unit and hospital stay, readmission, persistent cognitive deterioration and mortality. No effective preventive methods have been identified, but preliminary evidence suggests that EEG monitoring during general anaesthesia, by facilitating reduced anaesthetic exposure and EEG suppression, might decrease incident postoperative delirium...
2016: BMJ Open
Prudence J McRae, Philip J Walker, Nancye M Peel, Denise Hobson, Fiona Parsonson, Peter Donovan, Michael C Reade, Louise Marquart, Alison M Mudge
BACKGROUND: Preoperative frailty is an important predictor of poor outcomes but the relationship between frailty and geriatric syndromes is less clear. The aims of this study were to describe the prevalence of frailty and incidence of geriatric syndromes in a cohort of older vascular surgical ward patients, and investigate the association of frailty and other key risk factors with the occurrence of one or more geriatric syndromes (delirium, functional decline, falls, and/or pressure ulcers) and two hospital outcomes (acute length of stay and discharge destination)...
August 2016: Annals of Vascular Surgery
Ravi Bhat, M C B Santhosh, Venkatesh M Annigeri, Raghavendra P Rao
BACKGROUND: Goal of premedication in pediatric anesthesia are relieving pre and postoperative anxiety, good parental separation, and smooth induction of anesthesia. Anxiety can produce aggressive reactions, increased distress, increased postoperative pain and postoperative agitation. The benzodiazepine, midazolam, is the most frequently used premedication in pediatric anesthesia. Midazolam has a number of beneficial effects when used as premedication in children: Sedation, fast onset, and limited duration of action...
May 2016: Anesthesia, Essays and Researches
Wei-Che Lin, Chih-Cheng Huang, Hsiu-Ling Chen, Kun-Hsien Chou, Pei-Chin Chen, Nai-Wen Tsai, Meng-Hsiang Chen, Michael Friedman, Hsin-Ching Lin, Cheng-Hsien Lu
BACKGROUND: Systemic inflammation, neurocognitive impairments, and morphologic brain changes are associated with obstructive sleep apnea (OSA). Understanding their longitudinal evolution and interactions after surgical treatment provides clues to the pathogenesis of cognitive impairment and its reversibility. In the present study, we investigate clinical disease severity, systemic inflammation, cognitive deficits, and corresponding gray matter volume (GMV) changes in OSA, and the modifications following surgery...
2016: Journal of Translational Medicine
Hélène Imbeault, Lise Gagnon, Hélène Pigot, Sylvain Giroux, Nicolas Marcotte, Perrine Cribier-Delande, Julie Duval, Christian Bocti, Guy Lacombe, Tamás Fülöp, Nathalie Bier
AP@LZ is an electronic organiser that was designed to support the day-to-day activities of persons with Alzheimer's disease. To assess the potential of this technology, three participants (NI, JB, RD) were approached to take part in the study. They benefited from a structured cognitive intervention to learn how to operate AP@LZ; the intervention included the following learning stages: Acquisition, Application and Adaptation. Pre- and post-intervention measures were collected. NI, for whom a longitudinal study was conducted, still continued to use AP@LZ 24 months post-intervention...
April 28, 2016: Neuropsychological Rehabilitation
Hui-Lin Wang, Hua Liu, Zhang-Gang Xue, Qing-Wu Liao, Hao Fang
Although it is known that isoflurane exposure or surgery leads to post-operative cognitive dysfunction in aged rodents, there are few clinical interventions and treatments available to prevent this disorder. Minocycline (MINO) produces neuroprotection from several neurodegenerative diseases and various experimental animal models. Therefore, we set out to investigate the effects of MINO pre-treatment on isoflurane or surgery induced cognitive impairment in aged mice by assessing the hippocampal-dependent spatial memory performance using the Morris water maze task...
September 2016: Journal of Cellular and Molecular Medicine
P Kolh, S De Hert, P De Rango
The concept of risk assessment and the identification of surgical unfitness for vascular intervention is a particularly controversial issue today as the minimally invasive surgical population has increased not only in volume but also in complexity (comorbidity profile) and age, requiring an improved pre-operative selection and definition of high risk. A practical step by step (three steps, two points for each) approach for surgical risk assessment is suggested in this review. As a general rule, the identification of a "high risk" patient for vascular surgery follows a step by step process where the risk is clearly defined, quantified (when too "high"?), and thereby stratified based on the procedure, the patient, and the hospital, with the aid of predictive risk scores...
June 2016: European Journal of Vascular and Endovascular 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
Julia Day, David C Gillespie, Alasdair G Rooney, Helen J Bulbeck, Karolis Zienius, Florien Boele, Robin Grant
Neurocognitive deficits are common with brain tumors. If assessed at presentation using detailed neurocognitive tests, problems are detected in 80 % of cases. Neurocognition may be affected by the tumor, its treatment, associated medication, mood, fatigue, and insomnia. Interpretation of neurocognitive problems should be considered in the context of these factors. Early post-operative neurocognitive rehabilitation for brain tumor patients will produce rehabilitation outcomes (e.g., quality of life, improved physical function, subjective neurocognition) equivalent to stroke, multiple sclerosis, and head injury, but the effect size and duration of benefit needs further research...
May 2016: Current Treatment Options in Neurology
Olivia C Küster, Jonas Kösel, Stephanie Spohn, Niklas Schurig, Hayrettin Tumani, Christine A F von Arnim, Ingo Uttner
Individuals with higher cognitive reserve are more able to cope with pathological brain alterations, potentially due to the application of more efficient cognitive strategies. The extent to which an individual's cognitive performance can be increased by advantageous conditions differs substantially between patients with Alzheimer's dementia (AD) and healthy older adults and can be assessed with the Testing-the-Limits (TtL) approach. Thus, TtL has been proposed as a tool for the early diagnosis of AD. Here, we report the diagnostic accuracy of a memory TtL paradigm to discriminate between AD patients and controls...
March 29, 2016: Journal of Alzheimer's Disease: JAD
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