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Surgery cognitive

Vibhash D Sharma, Kelly E Lyons, Jules M Nazzaro, Rajesh Pahwa
INTRODUCTION: Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease (PD). However, its effect in older patients is not extensively studied, as they are often excluded from DBS surgery due to concerns of complications or reduced benefit. We assessed clinical outcomes after subthalamic nucleus (STN) DBS in older patients (age > 75 years) with PD. METHODS: All PD patients above 75 years who underwent STN-DBS between 1999 and 2015 were included...
February 11, 2019: Journal of the Neurological Sciences
Fu-Yuan Shih, Chia-Cheng Lin, Hung-Chen Wang, Jih-Tsun Ho, Chih-Hsiang Lin, Yan-Ting Lu, Wu-Fu Chen, Meng-Han Tsai
PURPOSE: Cranioplasty can improve a patient's psychosocial and cognitive functions after decompressive craniectomy, however seizures are a common complication after cranioplasty. The risk factors for early and late seizures after cranioplasty are unclear. This study is to evaluate the risk factors for early and late seizure after cranioplasty. METHODS: Two hundred and thirty-eight patients who received cranioplasty following craniectomy between January 2012 and December 2014 were included in this study...
December 19, 2018: Seizure: the Journal of the British Epilepsy Association
Minmin Yao, Zhimeng Zhao, Lan Wei, Di Zhou, Zhanggang Xue, Shengjin Ge
Postoperative cognitive dysfunction is common in the elderly. Endoplasmic reticulum stress (ER-stress) increases neuronal apoptosis after surgery, and chaperone molecules, such as heat shock proteins (HSPs), help reduce unfolded protein reactions, thereby promoting protein homeostasis. Mammal sirtuin1 (SIRT1)-mediated deacetylation of heat shock factor 1 (HSF1) upregulates HSF1 binding to the HSP70 promoter. Caloric restriction (CR) improves cognition in many neurodegenerative models. In this study, we evaluated whether CR improves impaired learning and memory after surgery by attenuating ER-stress in an SIRT1-dependent manner...
February 14, 2019: Experimental Gerontology
T Yang, G Xu, P T Newton, A S Chagin, S Mkrtchian, M Carlström, X-M Zhang, R A Harris, M Cooter, M Berger, K R Maddipati, K Akassoglou, N Terrando
BACKGROUND: Resolution of inflammation is an active and dynamic process after surgery. Maresin 1 (MaR1) is one of a growing number of specialised pro-resolving lipids biosynthesised by macrophages that regulates acute inflammation. We investigated the effects of MaR1 on postoperative neuroinflammation, macrophage activity, and cognitive function in mice. METHODS: Adult male C57BL/6 (n=111) and Ccr2RFP/+ Cx3cr1GFP/+ (n=54) mice were treated with MaR1 before undergoing anaesthesia and orthopaedic surgery...
March 2019: British Journal of Anaesthesia
Shaunte Baboumian, Spiro Pantazatos, Shiva Kothari, James McGinty, Jens Holst, Allan Geliebter
Of current obesity treatments, bariatric surgery induces the most weight loss. Given the marked increase in the number of bariatric surgeries performed, elucidating the mechanisms of action is a key research goal. We compared whole brain activation in response to high-energy dense (HED) vs. low-energy dense (LED) visual and auditory food cues before and approximately 4 months after Roux-en-Y Gastric Bypass (RYGB) (n = 16) and Sleeve Gastrectomy (SG) (n = 9). We included two control groups: a low-calorie diet weight loss group (WL) (n = 14) and a non-treatment group (NT) (n = 16)...
February 12, 2019: Neuroscience
Dominique Musselman, Neeta Shenvi, Amita Manatunga, Andrew H Miller, Edward Lin, Nana Gletsu-Miller
BACKGROUND: Neurobehavioral symptoms and cognitive dysfunction related to mood disorders are present in individuals with severe obesity. We sought to determine acute improvements in these symptoms and relationships with adiposity, inflammation, and insulin sensitivity after roux-en-y gastric bypass (RYGB) surgery. METHODS: The self-report Zung Depression Rating (ZDRS) and Neurotoxicity Rating (NRS) scales were administered before, and at 6-months after RYGB surgery in severely obese women (body mass index > 35 kg/m2 ; N = 19)...
February 11, 2019: Physiology & Behavior
Xuan Gao, Jiang Ming, Shiwen Liu, Bin Lai, Fang Fang, Jing Cang
The neurotoxicity of anesthetics on developing brain has been a focused issue for years. However, controversy exists between human and animal studies and surgery may be a potential reason for this. The discovery of glymphatic system, a pathway eliminating soluble substance from central nervous system (CNS), together with recent evidence that surgery-induced Aβ increase contributes to cognition dysfunction made us rethink about the influence of anesthetics on cognitive function. The function of glymphatic system was proved to be enhanced by sleep and sedation, so we assumed that under clinical situation Aβ1-40 whose accumulation played important role in cognitive dysfunction was increased by surgery and eliminated from CNS by glymphatic system...
February 11, 2019: Life Sciences
Ming-Yueh Chou, Yu-Chun Wang, Li-Ning Peng, Chih-Kuang Liang, Che-Sheng Chu, Mei-Chen Liao, Yu-Te Lin, Chien-Jen Hsu, Liang-Kung Chen
OBJECTIVES: To evaluate the roles of preoperative anemia and intra-operative blood transfusion in the development of post-operative delirium among older patients undergoing elective orthopedic surgery. METHODS: This prospective cohort study recruited subjects aged 60 years and over who were admitted for elective orthopedic surgery in a tertiary medical center during April 2011 to December 2013. Demographic data (age, gender, BMI, educational level), surgery-related factors (ASA class, type of anesthesia and surgery, intra-operative blood transfusion), results of geriatric assessment (hearing/visual impairment, cognition, depressive mood, comorbidity, malnutrition, polypharmacy, ADL, and IADL), laboratory data, length of hospital stay and the development of post-operative delirium were collected for analysis...
February 13, 2019: International Journal of Geriatric Psychiatry
Richard J Bryant, Catherine P Hobbs, Katie S Eyre, Lucy C Davies, Mark E Sullivan, William Shields, Prasanna Sooriakumaran, Clare L Verrill, Fergus V Gleeson, Ruth E MacPherson, Freddie C Hamdy, Simon F Brewster
PURPOSE: We hypothesized that 1) introducing prebiopsy multiparametric magnetic resonance imaging would increase the diagnostic yield of transrectal prostate biopsy and 2) this would inform recommendations regarding systematic transrectal prostate biopsy in the setting of negative prebiopsy multiparametric magnetic resonance imaging. MATERIALS AND METHODS: A total of 997 biopsy naïve patients underwent transrectal prostate biopsy alone to June 2016 (cohort 1) and thereafter 792 underwent transrectal prostate biopsy following prebiopsy multiparametric magnetic resonance imaging (cohort 2)...
March 2019: Journal of Urology
T Vogel, N Kohn, D Ostler, N Marahrens, N Samm, A Jell, M Kranzfelder, D Wilhelm, H Friess, H Feußner
BACKGROUND: The "magic triangle" in surgery and other disciplines consists of the demand for increasingly gentler forms of treatment, simultaneous cost reduction and the fundamental primacy of improving the quality of results. The digitalization of medicine offers a promising opportunity to do justice to this, also in the sense of "Surgery 4.0". The aim is to create a cognitive, collaborative diagnostics and treatment environment to support the surgeon. METHODS: In the sense of a "theory building" for analysis and planning, process modeling is the cornerstone for modern treatment planning...
February 13, 2019: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
David van Nieuwenhuizen, K Mariam Slot, Martin Klein, Dagmar Verbaan, Esther Sanchez Aliaga, Jan J Heimans, W Peter Vandertop, Saskia M Peerdeman, Jaap C Reijneveld
BACKGROUND: Studies on the associations between preoperative cerebral edema, cognitive functioning, and health-related quality of life (HRQOL) in WHO grade I meningioma patients are virtually lacking. We studied the association between preoperative cerebral edema on postoperative cognitive functioning and HRQOL 6 months postoperatively in WHO grade I meningioma patients. METHODS: Twenty-one consecutive WHO grade I meningioma patients, who underwent surgery, were matched individually for age, gender, and educational level to healthy controls...
February 13, 2019: Acta Neurochirurgica
Harikrishan S Sachdev, Bhairav Patel, Mark McManis, Mark Lee, Dave F Clarke
Intractable epilepsy may have a more severe effect on children in comparison to adults because the motor, sensorial, and cognitive functions of children are still undergoing development. For this same reason, however, children maintain a greater potential for recovery from intractable epilepsy because of the remaining cerebral plasticity. Thus, after 2 unsuccessful antiepileptic medications, surgical intervention is recommended. Pre-surgical localization of the epileptogenic zone increases seizure-freedom post-surgery by 200% to 300%...
February 12, 2019: Journal of Child Neurology
Elise F Nassif, Alexandre Arsène-Henry, Youlia M Kirova
Thirty per cent of cancer patients develop brain metastases, with multiple combination or sequential treatment modalities available, to treat systemic or central nervous system (CNS) disease. Most patients experience toxicities as a result of these treatments, of which cognitive impairment is one of the adverse events most commonly reported, causing major impairment of the patient's quality of life. Areas covered: This article reviews the role of cancer treatments in cognitive decline of patients with brain metastases: surgery, radiotherapy, chemotherapy, targeted therapies, immunotherapies and hormone therapy...
February 12, 2019: Expert Review of Anticancer Therapy
Sophie J M Rijnen, Ikram Meskal, Marjan Bakker, Wouter De Baene, Geert-Jan M Rutten, Karin Gehring, Margriet M Sitskoorn
Background: Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Methods: Patients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0), and 3 (T3) and 12 (T12) months after surgery. Patients' sociodemographically-corrected scores on 7 cognitive domains were compared to performance of a normative sample using one-sample z tests and Chi-square tests of independence...
February 7, 2019: Neuro-oncology
Srikant S Chakravarthi, Amin B Kassam, Melanie B Fukui, Alejandro Monroy-Sosa, Nichelle Rothong, Joseph Cunningham, Jonathan E Jennings, Neil Guenther, Jeremy Connelly, Tobias Kaemmerer, Kenneth C Nash, Mark Lindsay, Janie Rissell, Juanita M Celix, Richard A Rovin
BACKGROUND: Endoscopic and microneurosurgical approaches to third ventricular lesions are commonly performed under general anesthesia. OBJECTIVE: To report our initial experience with awake transsulcal parafascicular corridor surgery (TPCS) of the third ventricle and its safety, feasibility, and limitations. METHODS: A total of 12 cases are reviewed: 6 colloid cysts, 2 central neurocytomas, 1 papillary craniopharyngioma, 1 basal ganglia glioblastoma, 1 thalamic glioblastoma, and 1 ependymal cyst...
February 12, 2019: Operative Neurosurgery (Hagerstown, Md.)
Lauren A Beaupre, Jay S Magaziner, C Allyson Jones, Gian S Jhangri, D William C Johnston, Donna M Wilson, Sumit R Majumdar
Background: This study compared function three-months after hip fracture surgery between nursing home residents participating in a 10-week outreach rehabilitation program and those receiving usual care. Function, health-related quality of life (HRQL) and mortality were also compared over 12-months and outreach program feasibility was assessed. Methods: A feasibility trial was undertaken in Canadian nursing homes; of 77 participants, 46 were allocated to Outreach and 31 to Control prior to assessing function or cognition...
February 9, 2019: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Katja Schubert Samuelsson, Monika Egenvall, Inga Klarin, Johan Lökk, Ulf Gunnarsson
OBJECTIVES: We investigated the predictive value of specific tools used in a Comprehensive Geriatric Assessment (CGA) with regard to postoperative outcome in patients 75 years and older undergoing elective colorectal cancer (CRC) surgery. Furthermore, recovery was followed over the first postoperative year using the same assessment tools. MATERIAL AND METHODS: Baseline clinical and CGA variables including functional and nutritional status, pressure sore risk, fall risk, cognition, depression, polypharmacy, comorbidity, and health-related quality-of-life (HRQoL) were prospectively recorded...
February 7, 2019: Journal of Geriatric Oncology
Christopher L Tarola, Sameer Hirji, Steven J Yule, Jennifer M Gabany, Alessandro Zenati, Roger D Dias, Marco A Zenati
To address the, currently unmet, need for intra-operative safety-critical cognitive support in cardiac surgery, we have developed, validated, and implemented a series of customized checklists to address intra-operative emergencies, using a simulated operative setting. These crisis checklists are designed to provide cognitive and communication support to the operative team to reduce the likelihood of adverse events and improve adherence to best-practice guidelines. We recruited a number of content specialists including members of the hospital safety network and intraoperative cardiac surgery team members, and utilized a Delphi consensus method to develop procedure-specific guidelines for select intraoperative crises...
June 2018: 2018 IEEE Conference on Cognitive and Computational Aspects of Situation Management (CogSIMA): proceedings: Boston, MA, USA, 11-14 June 2018
Bennet A Butler, Cameron M Butler, Terrance D Peabody
Traditional apprenticeships have been used through history as a teaching model for wide variety of skills. These apprenticeships are characterized by practical, on-the-job training in which the apprentice observes and assists a master in the completion of a task, and thereby learns the skills needed to complete that task on his or her own. Cognitive apprenticeship is a modified version of this traditional teaching method which is differentiated from the traditional apprenticeship model primarily by its educational goals; cognitive apprenticeships are used to teach skills which require internal thought processes which cannot be readily observed externally by the teacher or the student...
February 6, 2019: Journal of Surgical Education
Anders Behrens, Eva Elgh, Göran Leijon, Bo Kristensen, Anders Eklund, Jan Malm
OBJECTIVEThe Computerized General Neuropsychological INPH Test (CoGNIT) provides the clinician and the researcher with standardized and accessible cognitive assessments in patients with idiopathic normal pressure hydrocephalus (INPH). CoGNIT includes tests of memory, executive functions, attention, manual dexterity, and psychomotor speed. Investigations of the validity and reliability of CoGNIT have been published previously. The aim of this study was to evaluate CoGNIT's sensitivity to cognitive change after shunt surgery in patients with INPH...
February 8, 2019: Journal of Neurosurgery
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