Critical Illness and Long-Term Cognitive Impairment

2017 ◽  
Author(s):  
Ramona O. Hopkins ◽  
Maria E. Carlo ◽  
James C. Jackson
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Critical Illness ◽  
Processing Speed ◽  
Financial Management ◽  
Medication Management ◽  
Risks Factors ◽  
The Impact

Evidence from dozens of studies of thousands of individuals suggest that as many as half of critical illness survivors experience significant deficits in memory, executive functioning, attention, and processing speed that persist years after discharge from the intensive care unit (ICU). This chapter reviews the prevalence, characteristics, possible mechanisms, and risk factors for long-term cognitive impairment after critical illness. Some key risks factors—notably, delirium—may be modifiable, whereas others, such as genetic markers, are not. Cognitive impairments are associated with psychiatric disorders, including depression, anxiety, and posttraumatic stress disorder. The impact of critical illness–related cognitive impairment on individuals and society includes financial costs, inability to return to work, impairments in instrumental activities of daily living (financial management, medication management, shopping, home care), reduced quality of life, and caregiver burden. Efforts need to be directed not only at modifying risk factors but also at attempting to prevent, treat, and remediate deficits.

Genetic Risk Factors For Long-Term Cognitive Impairment After Critical Illness

2010 ◽  
Author(s):  
Max L. Gunther ◽  
James C. Jackson ◽  
Pratik Pandharipande ◽  
Alessandro Morandi ◽  
Maureen Hahn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Critical Illness ◽  
Genetic Risk ◽  
Genetic Risk Factors

scholarly journals Potentially Modifiable Risk Factors for Long-Term Cognitive Impairment After Critical Illness: A Systematic Review

2018 ◽  
Vol 93 (1) ◽  
pp. 68-82 ◽  
Author(s):  
Amra Sakusic ◽  
John C. O'Horo ◽  
Mikhail Dziadzko ◽  
Dziadzko Volha ◽  
Rashid Ali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Critical Illness ◽  
Modifiable Risk Factors

scholarly journals Research of Budget Risks as a Factor of Influence on the Sustainable Development of Territories

2021 ◽  
Vol 101 ◽  
pp. 02026
Author(s):  
Irina Terentieva ◽  
Andrey Svistunov
Keyword(s):  
Risk Factors ◽  
Sustainable Development ◽  
Financial Management ◽  
Methodological Approach ◽  
Risk Indicators ◽  
Risk Category ◽  
The Sustainable Development ◽  
Correlation And Regression Analysis ◽  
The Impact

This article presents an overview of modern scientific research on budget risks as a factor influencing the sustainable development of territories. Certain aspects of the budget risk category were clarified based on an analysis of the existing conceptual framework of budget risk theory. The main types of budget risks are highlighted and the relationship between them is reflected. The main risk factors of the municipal budget corresponding to each type of risk were also identified. Also, recommendations on the methodology for assessing budget risks are provided. They are based on the use of correlation and regression analysis methods, as well as the simulation modeling of budget risk indicators. This methodological approach will allow for scenario analysis, stress testing of key budget indicators, and improvement of the quality of financial management. This will increase the resilience of budgets to the impact of uncertainty and risk factors.

scholarly journals TTP: long-term outcomes following recovery

Hematology ◽  
2018 ◽  
Vol 2018 (1) ◽  
pp. 548-552 ◽  
Author(s):  
James N. George
Keyword(s):  
Cognitive Impairment ◽  
Black Women ◽  
Lupus Erythematosus ◽  
Health Issues ◽  
Her Family ◽  
Treatment Of Depression ◽  
Young Black Women ◽  
The Impact

Abstract Although risk for relapse may be the greatest concern following recovery from acquired, autoimmune thrombotic thrombocytopenic purpura (TTP), there are multiple other major health issues that must be recognized and appropriately addressed. Depression may be the most common disorder following recovery from TTP and may be the most important issue for the patient’s quality of life. Severe or moderate depression has occurred in 44% of Oklahoma Registry patients. Recognition of depression by routine screening evaluations is essential; treatment of depression is effective. Minor cognitive impairment is also common. The recognition that cognitive impairment is related to the preceding TTP can provide substantial emotional support for both the patient and her family. Because TTP commonly occurs in young black women, the frequency of systemic lupus erythematosus, as well as other autoimmune disorders, is increased. Because there is a recognized association of TTP with pregnancy, there is always concern for subsequent pregnancies. In the Oklahoma Registry experience, relapse has occurred in only 2 of 22 pregnancies (2 of 13 women). The frequency of new-onset hypertension is increased. The most striking evidence for the impact of morbidities following recovery from TTP is decreased survival. Among the 77 patients who survived their initial episode of TTP (1995-2017), 16 (21%) have subsequently died, all before their expected age of death (median difference, 22 years; range 4-55 years). The conclusion from these observations is clear. Following recovery from TTP, multiple health problems occur and survival is shortened. Therefore, careful continuing follow-up is essential.

scholarly journals Long-Term Cognitive Dysfunction in Cancer Survivors

2021 ◽  
Vol 8 ◽  
Author(s):  
Zuzana Országhová ◽  
Michal Mego ◽  
Michal Chovanec
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cognitive Impairment ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Cognitive Dysfunction ◽  
Cognitive Symptoms ◽  
Cognitive Changes

Cancer-related cognitive impairment (CRCI) is a frequent side effect experienced by an increasing number of cancer survivors with a significant impact on their quality of life. Different definitions and means of evaluation have been used in available literature; hence the exact incidence of CRCI remains unknown. CRCI can be described as cognitive symptoms reported by cancer patients in self-reported questionnaires or as cognitive changes evaluated by formal neuropsychological tests. Nevertheless, association between cognitive symptoms and objectively assessed cognitive changes is relatively weak or absent. Studies have focused especially on breast cancer patients, but CRCI has been reported in multiple types of cancer, including colorectal, lung, ovarian, prostate, testicular cancer and hematological malignancies. While CRCI has been associated with various treatment modalities, including radiotherapy, chemotherapy, hormone therapy and novel systemic therapies, it has been also detected prior to cancer treatment. Therefore, the effects of cancer itself with or without the psychological distress may be involved in the pathogenesis of CRCI as a result of altered coping mechanisms after cancer diagnosis. The development of CRCI is probably multifactorial and the exact mechanisms are currently not completely understood. Possible risk factors include administered treatment, genetic predisposition, age and psychological factors such as anxiety, depression or fatigue. Multiple mechanisms are suggested to be responsible for CRCI, including direct neurotoxic injury of systemic treatment and radiation while other indirect contributing mechanisms are hypothesized. Chronic neuroinflammation mediated by active innate immune system, DNA-damage or endothelial dysfunction is hypothesized to be a central mechanism of CRCI pathogenesis. There is increasing evidence of potential plasma (e.g., damage associated molecular patterns, inflammatory components, circulating microRNAs, exosomes, short-chain fatty acids, and others), cerebrospinal fluid and radiological biomarkers of cognitive dysfunction in cancer patients. Discovery of biomarkers of cognitive impairment is crucial for early identification of cancer patients at increased risk for the development of CRCI or development of treatment strategies to lower the burden of CRCI on long-term quality of life. This review summarizes current literature on CRCI with a focus on long-term effects of different cancer treatments, possible risk factors, mechanisms and promising biomarkers.

Non-operative Risk Factors and the Implications of Sandostatin for Postoperative Pancreatic Fistula in Malignant Pancreatic Surgery

2018 ◽  
Vol 68 (12) ◽  
pp. 2875-2878
Author(s):  
Delia Rusu Andriesi ◽  
Ana Maria Trofin ◽  
Irene Alexandra Cianga Spiridon ◽  
Corina Lupascu Ursulescu ◽  
Cristian Lupascu
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Surgery ◽  
Postoperative Pancreatic Fistula ◽  
University Center ◽  
Preoperative Hemoglobin ◽  
Term Administration ◽  
Postoperative Administration

Pancreatic fistula is the most frecquent and severe postoperative complication after pancreatic surgery, with impressive implications for the quality of life and vital prognosis of the patient and for these reasons it is essential to identify risk factors. In the current study, who included 109 patient admitted to a single university center and who underwent pancreatic resection for malignant pathology, we assessed the following factors as risk factors: age, sex, preoperative hemoglobin value, preoperative total protein value, obesity and postoperative administration of sandostatin. Of the analyzed factors, it appears that only obesity and long-term administration of sandostatin influences the occurrence of pancreatic fistula.

scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

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