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IL-6, Delirium

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https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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 11, 2016: 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/25769330/-effects-of-dexmedetomidine-on-recovery-period-of-anesthesia-and-postoperative-cognitive-function-after-robot-assisted-laparoscopicradical-prostatectomy-in-the-elderly-people
#14
Lingling Ding, Hong Zhang, Weidong Mi, Yan He, Xu Zhang, Xin Ma, Hongzhao Li
OBJECTIVE: To evaluate the neuroprotective effect of dexmedetomidine on recovery period of anesthesia and postoperative cognitive function after robot assisted laparoscopicradical prostatectomy in the elderly people. METHODS: A total of 100 elderly patients who underwent robotic laparoscopic radical prostatectomy were divided into 2 groups: A dexmedetomidine group (n=50) and a control group (n=50). Patients in the dexmedetomidine group were given a loading dosage of dexmedetomidine [0...
February 2015: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/25471533/cognitive-changes-after-surgery-in-the-elderly-does-minimally-invasive-surgery-influence-the-incidence-of-postoperative-cognitive-changes-compared-to-open-colon-surgery
#15
COMPARATIVE STUDY
Christopher B Tan, Jackson Ng, Rajkumar Jeganathan, Fernando Kawai, Cynthia X Pan, Simcha Pollock, James Turner, Steven Cohen, Mitchell Chorost
BACKGROUND: Postoperative delirium in the elderly is a growing concern. Data regarding significant differences in postoperative cognitive dysfunction (POCD) in elderly persons undergoing laparoscopic versus open colon resection are not well established. OBJECTIVES: The goal of this study was to compare the incidence of POCD in laparoscopic versus open colon surgery in an elderly population. DESIGN AND SETTING: A prospective nonrandomized pilot study was conducted at an urban tertiary care hospital...
2015: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/25413160/neopterin-a-potential-biomarker-for-delirium-in-elderly-patients
#16
Angelique Egberts, Eline H A Wijnbeld, Durk Fekkes, Milly A van der Ploeg, Gijsbertus Ziere, Herbert Hooijkaas, Tischa J M van der Cammen, Francesco U S Mattace-Raso
BACKGROUND/AIMS: The diagnosis of delirium is not supported by specific biomarkers. In a previous study, high neopterin levels were found in patients with a postoperative delirium. In the present study, we investigated levels of neopterin, interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in acutely ill admitted elderly patients with and without a delirium. METHODS: Plasma/serum levels of neopterin, IL-6 and IGF-1 were determined in patients aged ≥65 years admitted to the wards of Internal Medicine and Geriatrics...
2015: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/25368603/pre-operative-high-il-6-blood-level-is-a-risk-factor-of-post-operative-delirium-onset-in-old-patients
#17
Miriam Capri, Stella Lukas Yani, Rabih Chattat, Daniela Fortuna, Laura Bucci, Catia Lanzarini, Cristina Morsiani, Fausto Catena, Luca Ansaloni, Marco Adversi, Maria Rita Melotti, Gianfranco Di Nino, Claudio Franceschi
BACKGROUND: Post-operative delirium (POD) is a common complication in elderly patients undergoing surgery, but the underpinning causes are not clear. We hypothesized that inflammaging, the subclinical low and chronic grade inflammation characteristic of old people, can contribute to POD onset. Accordingly, we investigated the association of pre-operative and circulating cytokines in elderly patients (>65 years), admitted for elective and emergency surgery. METHODS: This is a secondary analysis of a sub-cohort of patients belonging to a previous large case-control study, where 351 patients were clinically and cognitively thoroughly characterized, together with the assessment of POD (47 patients) by confusion assessment method and delirium rating scale...
2014: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/25253547/cool-extremities-a-diagnostic-sign-recorded-in-shang-han-lun-still-good-prognosis-index-for-septic-patients-in-today-s-medical-intensive-care-unit
#18
Yung-Yen Cheng, Sunny Jui-Shan Lin, Chih-Hung Chang, Chien-Jung Lin, Chen-Chen Tsai, Yi-Chang Su
OBJECTIVE: To evaluate and compare the predictive value of the physical signs mentioned by ZHANG Zhong-jing in Treatise on Cold Damaged Diseases (Shang Han Lun), together with other clinically determined diagnostic scores and laboratory values in modern medicine on 28-day mortality in septic patients. METHODS: Three-year prospective observation was conducted in medical intensive care unit in two local community hospitals. In all, 126 patients with severe sepsis and/or septic shock were consecutively enrolled...
September 24, 2014: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/25135124/impact-of-oral-melatonin-on-critically-ill-adult-patients-with-icu-sleep-deprivation-study-protocol-for-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Huawei Huang, Li Jiang, Ling Shen, Guobin Zhang, Bo Zhu, Jiajia Cheng, Xiuming Xi
BACKGROUND: Sleep deprivation is common in critically ill patients in intensive care units (ICU). It can result in delirium, difficulty weaning, repeated nosocomial infections, prolonged ICU length of stay and increased ICU mortality. Melatonin, a physiological sleep regulator, is well known to benefit sleep quality in certain people, but evidence for the effectiveness in ICU sleep disturbance is limited. METHODS/DESIGN: This study has a prospective, randomized, double-blind, controlled, parallel-group design...
August 18, 2014: Trials
https://www.readbyqxmd.com/read/24886875/inflammation-biomarkers-and-delirium-in-critically-ill-patients
#20
Cristiane Ritter, Cristiane D Tomasi, Felipe Dal-Pizzol, Bernardo Bollen Pinto, Alex Dyson, Aline S de Miranda, Clarissa M Comim, Márcio Soares, Antonio L Teixeira, João Quevedo, Mervyn Singer
INTRODUCTION: Delirium is a common occurrence in critically ill patients and is associated with an increase in morbidity and mortality. Septic patients with delirium may differ from a general critically ill population. The aim of this investigation was to study the relationship between systemic inflammation and the development of delirium in septic and non-septic critically ill patients. METHODS: We performed a prospective cohort study in a 20-bed mixed intensive care unit (ICU) including 78 (delirium = 31; non-delirium = 47) consecutive patients admitted for more than 24 hours...
May 23, 2014: Critical Care: the Official Journal of the Critical Care Forum
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