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IL-6, Delirium

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https://www.readbyqxmd.com/read/29678619/effect-of-goal-directed-fluid-therapy-on-early-cognitive-function-in-elderly-patients-with-spinal-stenosis
#1
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/29669581/reduced-ex-vivo-release-of-pro-inflammatory-cytokines-and-elevated-plasma-interleukin-6-are-inflammatory-signatures-of-post-stroke-delirium
#2
Katarzyna Kowalska, Elzbieta Klimiec, Kazimierz Weglarczyk, Joanna Pera, Agnieszka Slowik, Maciej Siedlar, Tomasz Dziedzic
BACKGROUND: Experimental studies suggest that systemic inflammation contributes to the pathophysiology of delirium. The aim of our study was to determine blood-derived inflammatory signatures of post-stroke delirium. METHODS: We included 144 ischemic stroke patients. We assessed delirium on a daily basis during the first 7 days of hospitalization. Venous blood was collected at day 3 after the onset of stroke and stimulated ex vivo with lipopolysaccharide (LPS)...
April 18, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29549829/the-effect-of-the-timing-and-dose-of-dexmedetomidine-on-postoperative-delirium-in-elderly-patients-after-laparoscopic-major-non-cardiac-surgery-a-double-blind-randomized-controlled-study
#3
Cheol Lee, Cheol Hyeong Lee, Gilho Lee, Myeongjong Lee, Jihyo Hwang
STUDY OBJECTIVE: There were few clinical data dosing and timing regimen for preventing postoperative delirium. The present study aimed to investigate the effect of the timing and dose of dexmedetomidine on postoperative delirium in elderly patients after laparoscopic major non-cardiac surgery. PATIENTS AND INTERVENTIONS: A total of 354 patients >65 years of age undergoing laparoscopic major non-cardiac surgery under general anesthesia received a dexmedetomidine 1 μg/kg bolus followed by 0...
June 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29529166/development-of-a-dynamic-multi-protein-signature-of-postoperative-delirium
#4
Sarinnapha M Vasunilashorn, Long H Ngo, Noel Y Chan, Wenxiao Zhou, Simon T Dillon, Hasan H Otu, Sharon K Inouye, Iris Wyrobnik, George A Kuchel, Janet E McElhaney, Zhongcong Xie, David C Alsop, Richard N Jones, Towia A Libermann, Edward R Marcantonio
Background: Delirium is common, morbid, and costly, yet its biology is poorly understood. We aimed to develop a multi-protein signature of delirium by identifying proteins associated with delirium from unbiased proteomics and combining them with delirium biomarkers identified in our prior work (interleukin [IL]-6 and IL-2). Methods: We used the Successful Aging after Elective Surgery (SAGES) Study of adults age ≥70 undergoing major non-cardiac surgery (N=560; 24% delirium)...
February 24, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29374667/epidurals-in-pancreatic-resection-outcomes-e-pro-study-protocol-for-a-randomised-controlled-trial
#5
Linda Ma Pak, Simon Haroutounian, William G Hawkins, Lori Worley, Monika Kurtz, Karen Frey, Menelaos Karanikolas, Robert A Swarm, Michael M Bottros
INTRODUCTION: Epidural analgesia provides an important synergistic method of pain control. In addition to reducing perioperative opioid consumption, the deliverance of analgesia into the epidural space, effectively creating a sympathetic blockade, has a multitude of additional potential benefits, from decreasing the incidence of postoperative delirium to reducing the development of persistent postsurgical pain (PPSP). Prior studies have also identified a correlation between the use of epidural analgesia and improved oncological outcomes and survival...
January 26, 2018: BMJ Open
https://www.readbyqxmd.com/read/29187700/sevoflurane-preconditioning-ameliorates-lipopolysaccharide-induced-cognitive-impairment-in-mice
#6
Maiko Satomoto, Zhongliang Sun, Yushi U Adachi, Hiroyuki Kinoshita, Koshi Makita
Systemic inflammation induces brain neuronal inflammation, in turn causing acute cognitive disorders. Furthermore, neuronal inflammation is one cause of postoperative cognitive disorder (POCD) and delirium. However, no sufficiently established pharmacological treatment is available for neurocognitive inflammation. This study evaluated the possible neuroprotective effects of preconditioning with sevoflurane anesthesia on cognition and neuroinflammatory changes in an animal model of lipopolysaccharide (LPS)-induced systemic inflammation...
November 29, 2017: Experimental Animals
https://www.readbyqxmd.com/read/29164173/factors-related-to-the-severity-of-delirium-in-the-elderly-patients-with-infection
#7
R A Tuty Kuswardhani, Yosef Samon Sugi
Objective: Delirium is a common neuropsychiatric syndrome in the elderly characterized by concurrent impairments in cognition and behavior. Infection is one of the most important risk factors for delirium. The objective of this study is to elaborate the factors related to the severity of delirium in the elderly patients with infection. Method: An observational study on the relationship of several clinical parameters and the severity of delirium in elderly patients (more than 60 years) with infection was conducted at Geriatric Inpatient Ward, Sanglah Hospital...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#8
Xi Xin, Fei Xin, Xuguang Chen, Qi Zhang, Yanan Li, Shuping Huo, Chongfu Chang, Qiujun Wang
BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. METHODS: This prospective study recruited 120 geriatric patients who underwent hip surgery. The patients were randomly divided into two groups: control group (NS group) and HS group. Patients in the NS group were pre-injected with 4 mL/kg isotonic saline, and those in the HS group were pre-injected with 4 mL/kg 7...
November 14, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29081151/-effects-of-preconditioning-with-hypertonic-saline-solution-on-postoperative-delirium-in-the-aged
#9
X Xin, S P Huo, Q Zhang, Y N Li, L Wang, Q J Wang
Objective: To evaluate and explore the mechanism of the effect of hypertonic pre-injection on postoperative delirium in the aged. Methods: From June 2016 to February 2017, participants scheduled hip arthroplasty surgery were randomly divided into four groups: Group 1 (H1) 30 patients pre-injected 4 ml/kg hypertonic solution were proceeded general anesthesia; Group 2 (H2) 30 patients pre-injected 4 ml/kg hypertonic solution were proceeded spinal canal anesthesia; Group 3 (C1) 30 patients pre-injected 4 ml/kg isotonic saline were proceeded general anesthesia; Group 4 (C2) 30 patients pre-injected 4 ml/kg isotonic saline were proceeded spinal canal anesthesia in Department of Anesthesiology, Third Hospital of Hebei Medical University...
October 24, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28587598/methodologic-considerations-in-the-design-and-analysis-of-nested-case-control-studies-association-between-cytokines-and-postoperative-delirium
#10
Long H Ngo, Sharon K Inouye, Richard N Jones, Thomas G Travison, Towia A Libermann, Simon T Dillon, George A Kuchel, Sarinnapha M Vasunilashorn, David C Alsop, Edward R Marcantonio
BACKGROUND: The nested case-control study (NCC) design within a prospective cohort study is used when outcome data are available for all subjects, but the exposure of interest has not been collected, and is difficult or prohibitively expensive to obtain for all subjects. A NCC analysis with good matching procedures yields estimates that are as efficient and unbiased as estimates from the full cohort study. We present methodological considerations in a matched NCC design and analysis, which include the choice of match algorithms, analysis methods to evaluate the association of exposures of interest with outcomes, and consideration of overmatching...
June 6, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28338180/influence-of-dexmedetomidine-to-cognitive-function-during-recovery-period-for-children-with-general-anesthesia
#11
RANDOMIZED CONTROLLED TRIAL
Z-M Jia, H-N Hao, M-L Huang, D-F Ma, X-L Jia, B Ma
OBJECTIVE: We studied the influence of Dexmedetomidine on cognitive function in children during the recovery period of general anesthesia. PATIENTS AND METHODS: Ninety-three children who underwent general anesthesia were selected and randomly divided into (1) the control group, (2) the dexmedetomidine group, and (3) the dezocine group. Fentanyl, propofol, and rocuronium were used in all patients to induce anesthesia, while sevoflurane inhalation and propofol were used to maintain anesthesia...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28088641/pathophysiological-and-behavioral-effects-of-systemic-inflammation-in-aged-and-diseased-rodents-with-relevance-to-delirium-a-systematic-review
#12
REVIEW
Leroy Schreuder, B J Eggen, Knut Biber, Regien G Schoemaker, Jon D Laman, Sophia E de Rooij
Delirium is a frequent outcome for aged and demented patients that suffer a systemic inflammatory insult. Animal models that reconstruct these etiological processes have potential to provide a better understanding of the pathophysiology of delirium. Therefore, we systematically reviewed animal studies in which systemic inflammation was superimposed on aged or diseased animal models. In total, 77 studies were identified. Aged animals were challenged with a bacterial endotoxin in 29 studies, 25 studies superimposed surgery on aged animals, and in 6 studies a bacterial infection, Escherichia coli (E...
May 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27730511/p2x7-receptor-signaling-contributes-to-sepsis-associated-brain-dysfunction
#13
Luiz Eduardo Baggio Savio, Mariana G Juste Andrade, Paola de Andrade Mello, Patrícia Teixeira Santana, Aline Cristina Abreu Moreira-Souza, Janaína Kolling, Aline Longoni, Linda Feldbrügge, Yan Wu, Angela T S Wyse, Simon C Robson, Robson Coutinho-Silva
Sepsis results in unfettered inflammation, tissue damage, and multiple organ failure. Diffuse brain dysfunction and neurological manifestations secondary to sepsis are termed sepsis-associated encephalopathy (SAE). Extracellular nucleotides, proinflammatory cytokines, and oxidative stress reactions are associated with delirium and brain injury, and might be linked to the pathophysiology of SAE. P2X7 receptor activation by extracellular ATP leads to maturation and release of IL-1β by immune cells, which stimulates the production of oxygen reactive species...
October 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/27633985/systemic-tnf-%C3%AE-produces-acute-cognitive-dysfunction-and-exaggerated-sickness-behavior-when-superimposed-upon-progressive-neurodegeneration
#14
Edel Hennessy, Shane Gormley, Ana Belen Lopez-Rodriguez, Caoimhe Murray, Carol Murray, Colm Cunningham
Inflammation influences chronic neurodegeneration but its precise roles are not yet clear. Systemic inflammation caused by infection, trauma or co-morbidity can alter the brain's inflammatory status, produce acute cognitive impairments, such as delirium, and drive new pathology and accelerated decline. Consistent with this, elevated systemic TNF-α is associated with more rapid cognitive decline over 6months in Alzheimer's disease patients. In the current study we challenged normal animals and those with existing progressive neurodegeneration (ME7 prion disease) with TNF-α (i...
January 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27577265/perioperative-cerebrospinal-fluid-and-plasma-inflammatory-markers-after-orthopedic-surgery
#15
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...
August 30, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27341529/associations-between-delirium-and-preoperative-cerebrospinal-fluid-c-reactive-protein-interleukin-6-and-interleukin-6-receptor-in-individuals-with-acute-hip-fracture
#16
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/26895206/microelectrode-recording-mer-findings-during-sleep-awake-anesthesia-using-dexmedetomidine-in-deep-brain-stimulation-surgery-for-parkinson-s-disease
#17
Woo-Keun Kwon, Jong Hyun Kim, Ji-Hye Lee, Byung-Gun Lim, Il-ok Lee, Seong Beom Koh, Taek Hyun Kwon
OBJECTIVE: The preferred choice of anesthesia for deep brain stimulation (DBS) has been local anesthesia due to the need of patients' cooperation during the procedure, and concern on the interference of sedatives on microelectrode recording (MER) results. However, local anesthesia during the whole procedure may be impossible in some patients due to uncontrolled anxiety, fear, delirium or exhaustion. Therefore, sedative drugs have been used for DBS, but findings of MER during the procedures have not been reported in detail, especially in the globus pallidus internus (GPi)...
April 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/26545149/effects-of-dexmedetomidine-on-emergence-delirium-in-pediatric-cardiac-surgery
#18
RANDOMIZED CONTROLLED TRIAL
Yingying Sun, Junxia Liu, Xianren Yuan, Yuanhai Li
BACKGROUND: The present study aimed to investigate the effects of dexmedetomidine on emergence delirium (ED) in pediatric patients undergoing cardiac surgery. METHODS: Fifty children of both sexes aged 1-6 years weighing 10-25 kilograms, with American Society of Anesthesiologists (ASA) physical status grade II, undergoing sevoflurane-based general anesthesia for elective cardiac surgery, were randomly assigned to two groups. The dexmedetomidine group (group D, N...
June 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/26379954/effects-of-dexmedetomidine-on-anesthesia-recovery-period-and-postoperative-cognitive-function-of-patients-after-robot-assisted-laparoscopic-radical-cystectomy
#19
Lingling Ding, Hong Zhang, Weidong Mi, Tao Wang, Yan He, Xu Zhang, Xin Ma, Hongzhao Li
OBJECTIVE: The purpose of the study was to evaluate the neuroprotective effect of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. METHODS: A total of 40 elective patients who would undergo robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. They were randomly divided into two groups in a double-blind manner. After pneumoperitoneum established, all patients adopted 40° trendelenberg position...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26048578/systemic-inflammation-and-microglial-activation-systematic-review-of-animal-experiments
#20
REVIEW
Inge C M Hoogland, Carin Houbolt, David J van Westerloo, Willem A van Gool, Diederik van de Beek
BACKGROUND: Animal studies show that peripheral inflammatory stimuli may activate microglial cells in the brain implicating an important role for microglia in sepsis-associated delirium. We systematically reviewed animal experiments related to the effects of systemic inflammation on the microglial and inflammatory response in the brain. METHODS: We searched PubMed between January 1, 1950 and December 1, 2013 and Embase between January 1, 1988 and December 1, 2013 for animal studies on the influence of peripheral inflammatory stimuli on microglia and the brain...
June 6, 2015: Journal of Neuroinflammation
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