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Cognitive preoperative prognostication

Ellen W S Carbo, Arjan Hillebrand, Edwin van Dellen, Prejaas Tewarie, Philip C de Witt Hamer, Johannes C Baayen, Martin Klein, Jeroen J G Geurts, Jaap C Reijneveld, Cornelis J Stam, Linda Douw
Resective neurosurgery carries the risk of postoperative cognitive deterioration. The concept of 'hub (over)load', caused by (over)use of the most important brain regions, has been theoretically postulated in relation to symptomatology and neurological disease course, but lacks experimental confirmation. We investigated functional hub load and postsurgical cognitive deterioration in patients undergoing lesion resection. Patients (n = 28) underwent resting-state magnetoencephalography and neuropsychological assessments preoperatively and 1-year after lesion resection...
February 7, 2017: Scientific Reports
Sebastian Müller, Hatem Al-Fadel Saleh, Marcel Jakob, Nicholas A Beckmann, Bojana Savic, Daniel Rikli, Norbert Suhm
INTRODUCTION: Geriatric hip fracture patients are a highly heterogeneous collective, what distinctly aggravates the best possible treatment. Consequently, it is becoming more important to identify selection criteria that can distinguish those patients who can benefit the most from treatment in a geriatric fracture center. In our pilot study, we assessed the 2007 published Penrod score for its utility as a useful selection tool by prospectively comparing our own patient's outcome with the Penrod study...
August 2016: Archives of Orthopaedic and Trauma Surgery
Bart M G Baekelandt, Marianne J Hjermstad, Tom Nordby, Morten W Fagerland, Elin H Kure, Turid Heiberg, Trond Buanes, Knut J Labori
BACKGROUND: The purpose of this prospective study was to evaluate whether pre-surgery health-related quality of life (HRQoL) and subjectively rated symptom scores are prognostic factors for survival in patients with resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients undergoing pancreatic resection for PDAC completed the Edmonton Symptom Assessment System (ESAS) and the EORTC QLQ-C30 and QLQ-PAN26 questionnaires preoperatively. Patient, tumor and treatment characteristics, recurrence and survival were registered...
March 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Timothy C Ryken, Ian Parney, John Buatti, Steven N Kalkanis, Jeffrey J Olson
QUESTIONS: (1) What is the optimal role of external beam radiotherapy in the management of adult patients with newly diagnosed low-grade glioma (LGG) in terms of improving outcome (i.e., survival, complications, seizure control or other reported outcomes of interest)? (2) Which radiation strategies (dose, timing, fractionation, stereotactic radiation, brachytherapy, chemotherapy) improve outcomes compared to standard external beam radiation therapy in the initial management of low grade gliomas in adults? (3) Do specific factors (e...
December 2015: Journal of Neuro-oncology
Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Chihiro Akiba, Hidenori Sugano, Takeshi Hara, Keiko Fusegi, Kostadin Karagiozov, Hajime Arai
The prognosis of cognitive improvement after cerebrospinal fluid (CSF) shunting in idiopathic normal pressure hydrocephalus (iNPH) remains uncertain, with no reports on CSF biomarkers related to long-term cognitive prognosis. We performed a preliminary study of CSF biomarker protein levels for cognitive outcome prognostication of two-year outcomes after shunt treated iNPH in 36 patients (13 women) with a median age of 75years (IQR 69-78). CSF biomarkers included soluble amyloid precursor proteins (sAPP, sAPPα, sAPPβ), amyloid β (Aβ)1-38, Aβ1-42 and phosphorylated tau (p-tau), lipocalin-type prostaglandin D synthase (L-PGDS)/β-trace, and cystatin C...
October 15, 2015: Journal of the Neurological Sciences
Shang-Ming Chiou
BACKGROUND: A few reports have addressed the sex-related efficacy of deep brain stimulation (DBS) in the subthalamic nucleus (STN) to treat advanced Parkinson disease (PD). The present study evaluates the sex-related prognostic factors for STN-DBS outcomes. METHODS: Seventy-two consecutive patients (48 men and 24 women) were reviewed retrospectively. Changes in the Unified PD Rating Scale scores were compared between men and women in the 6-month drug-off/DBS-on state relative to the preoperative drug-off baseline...
October 2015: World Neurosurgery
Shobhit V Minhas, Ian Chow, David S Feldman, Joseph Bosco, Norman Y Otsuka
BACKGROUND: Pediatric scoliosis often requires operative treatment, yet few studies have examined readmission rates in this patient population. The purpose of this study is to examine the incidence, reasons, and independent risk factors for 30-day unplanned readmissions following scoliosis surgery. METHODS: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement-Pediatric database from 2012 to 2013 was performed. Patients undergoing spinal arthrodesis for progressive infantile scoliosis, idiopathic scoliosis, or scoliosis due to other medical conditions were identified and divided between 2 groups: patients with unplanned 30-day readmissions (Readmitted) and patients with no unplanned readmissions (Non-Readmitted)...
March 2016: Journal of Pediatric Orthopedics
J Hirsch, G DePalma, T T Tsai, L P Sands, J M Leung
INTRODUCTION: Postoperative delirium is common in older patients. Despite its prognostic significance, the pathophysiology is incompletely understood. Although many risk factors have been identified, no reversible factors, particularly ones potentially modifiable by anaesthetic management, have been identified. The goal of this prospective cohort study was to investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing major non-cardiac surgery...
September 2015: British Journal of Anaesthesia
Daegu Lee, Jae Yong Jo, Ji Sun Jung, Sang Jun Kim
OBJECTIVE: To investigate the prognostic factors predicting the recovery of pre-fracture functional mobility, we evaluated this by the use of ambulatory assistive devices in short-term follow-up. METHODS: Five hundred and fifty-three elderly patients who had undergone hip fracture operations from January 2006 to June 2013 were enrolled in this retrospective study. Clinical characteristics and predicted factors affecting functional recovery, such as the delay of rehabilitation after the operation, were reviewed...
December 2014: Annals of Rehabilitation Medicine
Lawrence S Long, Jed T Wolpaw, Jacqueline M Leung
BACKGROUND: Preoperative cognitive impairment is a major risk factor for postoperative delirium. We therefore investigated the prognostic significance and feasibility of administering a brief cognitive screen before surgery. METHODS: Patients > 65 yr of age undergoing hip, knee, or spine surgery were enrolled. A 60-sec cognitive screen, the animal fluency test (AFT), was administered preoperatively. Postoperative delirium was measured using a chart-based tool previously validated using criteria from the Confusion Assessment Method...
June 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Megan A Feng, Daniel T McMillan, Karen Crowell, Hyman Muss, Matthew E Nielsen, Angela B Smith
BACKGROUND: The comprehensive geriatric assessment (CGA) has developed as an important prognostic tool to risk stratify older adults and has recently been applied to the surgical field. In this systematic review, we examined the utility of CGA components as predictors of adverse outcomes among geriatric patients undergoing major oncologic surgery. MATERIALS AND METHODS: MEDLINE, Embase, and the Cochrane Library were searched for prospective studies examining the association of components of the CGA with specific outcomes among geriatric patients undergoing elective oncologic surgery...
January 2015: Journal of Surgical Research
Maren Schmidt, Bruno Neuner, Andrea Kindler, Kathrin Scholtz, Rahel Eckardt, Peter Neuhaus, Claudia Spies
OBJECTIVE: Aim of this study was to evaluate the association between preoperative health-related quality of life (HRQoL) and mortality in a cohort of elderly patients (>65 years) with gastrointestinal, gynecological and genitourinary carcinomas. DESIGN: Prospective cohort pilot study. SETTING: Tertiary university hospital in Germany. PATIENTS: Between June 2008 and July 2010 and after ethical committee approval and written informed consent, 126 patients scheduled for onco-surgery were included...
2014: PloS One
Takeo Uzuka, Kenichiro Asano, Toshio Sasajima, Kaori Sakurada, Toshihiro Kumabe, Takaaki Beppu, Masahiro Ichikawa, Chifumi Kitanaka, Hiroshi Aoki, Kiyoshi Saito, Kuniaki Ogasawara, Teiji Tominaga, Kazuo Mizoi, Hiroki Ohkuma, Yukihiko Fujii, Takamasa Kayama
Age is one of the most important prognostic factors in glioblastoma patients, but no standard treatment has been established for elderly patients with this condition. We therefore conducted a retrospective cohort study to evaluate treatment regimens and outcomes in elderly glioblastoma patients. The study population consisted of 79 glioblastoma patients aged ≥ 76 years (median age 78.0 years; 34 men and 45 women). The median preoperative Karnofsky performance status (KPS) score was 60. Surgical procedures were classified as biopsy (31 patients, 39...
January 2014: Journal of Neuro-oncology
Kaisorn L Chaichana, Shami Acharya, Mariana Flores, Olindi Wijesekera, Daniele Rigamonti, Jon D Weingart, Alessandro Olivi, Chetan Bettegowda, Gary L Gallia, Henry Brem, Michael Lim, Alfredo Quinones-Hinojosa
OBJECTIVE: The management of patients with brain metastases is typically dependent on their prognosis. Recursive partitioning analysis (RPA) is the most commonly used method for prognosticating survival, but has limitations for patients in the intermediate class. The aims of this study were to ascertain preoperative risk factors associated with survival, develop a preoperative prognostic grading system, and evaluate the utility of this system in predicting survival for RPA class 2 patients...
July 2014: World Neurosurgery
Paul Willems
Chronic low back pain (CLBP) is one of the main causes of disability in the western world with a huge economic burden to society. As yet, no specific underlying anatomic cause has been identified for CLBP. Imaging often reveals degenerative findings of the disc or facet joints of one or more lumbar motion segments. These findings, however, can also be observed in asymptomatic people. It has been suggested that pain in degenerated discs may be caused by the ingrowth of nerve fibers into tears or clefts of the annulus fibrosus or nucleus pulposus, and by reported high levels of pro-inflammatory mediators...
February 2013: Acta Orthopaedica. Supplementum
Lasse J Lapidus, Anastasios Charalampidis, Johanna Rundgren, Anders Enocson
OBJECTIVE: To analyze factors influencing the reoperation rate due to fracture healing complications after internal fixation of Garden I and II femoral neck fractures with special reference to a new validated method assessing the preoperative posterior tilt on lateral radiographs. DESIGN: Prospective cohort study. SETTING: Level II trauma center. PATIENTS: A consecutive cohort of 382 hips in 379 patients who underwent internal fixation for a Garden I or II femoral neck fracture...
July 2013: Journal of Orthopaedic Trauma
Ines Lazibat, Zeljko Sutlić, Kristina Brkić, Branimir Nevajda, Jozica Sikić, Ana Havelka Mestrović
The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100P in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N = 30) and off-pump group (CPB-, N = 32)...
September 2012: Collegium Antropologicum
J Schön, H Paarmann, M Heringlake
The determination of cerebral oxygen saturation (S(c)O(2)) by means of near-infrared spectroscopy allows non-invasive assessment of the cerebral oxygen delivery and demand ratio in the frontal cortex region. Studies in cardiac as well as non-cardiac patients have shown that maintaining S(c)O(2) in the preoperative range reduces the incidence of postoperative cognitive dysfunction and general morbidity; however, S(c)O(2) is not only reflective of cerebral but also of systemic oxygen balance, is inversely related to cardiopulmonary function and has prognostic relevance in cardiac surgery patients...
November 2012: Der Anaesthesist
Rebecca A Cleary, Pamela J Thompson, Zoe Fox, Jacqueline Foong
PURPOSE: Neurosurgery is an effective therapy for selected individuals with medically refractory temporal lobe epilepsy (TLE). De novo psychopathology may complicate the postsurgical outcome. Our aims were to identify predictors of de novo psychiatric and seizure outcome following TLE surgery. METHODS: Medical records of 280 patients who underwent TLE surgery were reviewed. Preoperative and postoperative psychiatric diagnoses were identified, in addition to information on seizure recurrence and neuropsychological status...
October 2012: Epilepsia
Barbara Santini, Andrea Talacchi, Francesca Casagrande, Marilena Casartelli, Silvia Savazzi, Francesco Procaccio, Massimo Gerosa
BACKGROUND: Although generally well tolerated, awake craniotomy is burdened by non-negligible failure rates. The aim of this pilot study was to verify the feasibility of a wider research scope to define objective criteria for patient exclusion and the risk of intraoperative mapping failures. METHODS: Twenty-one patients with brain tumors were subjected to a procedure in 3 steps: neuropsychological criteria for both cognition and language; psychological questionnaires for anxiety, attitude to pain and depression, and psychophysiological monitoring for the candidate's capacity for self-control; and an intraoperative interview for the patient's perception during awake procedure...
July 2012: Journal of Neurosurgical Anesthesiology
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