scholarly journals Long-term cognitive outcomes among unselected ventilated and non-ventilated ICU patients

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
José Raimundo A. de Azevedo ◽  
Widlani Sousa Montenegro ◽  
Djane Pereira Rodrigues ◽  
Suellen C. de C. Souza ◽  
Vanessa F. S. Araujo ◽  
...  
Keyword(s):  
Cognitive Outcomes ◽  
Icu Patients

scholarly journals Long-Term Cognitive Impairment After Critical Illness

2018 ◽  
pp. 86-90
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cognitive Impairment ◽  
Critical Illness ◽  
Cognitive Outcomes ◽  
Adult Patients ◽  
Illness Experience ◽  
Icu Patients ◽  
Global Cognition

This case focuses on long-term cognitive impairment after critical illness by asking the question: What is the prevalence of long-term cognitive impairment after critical illness, and does the duration of delirium and use of sedative or analgesic medications affect cognitive outcomes? This study demonstrated that 74% of adult patients with critical illness experience delirium during their hospital course. Furthermore, patients in the intensive care unit (ICU) setting commonly experience global cognition and executive function deficits at 3 and 12 months following hospitalization. These findings highlight the importance of careful delirium surveillance in ICU patients.

scholarly journals Influences on catch-up growth using relative versus absolute metrics: evidence from the MAL-ED cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie A. Richard ◽  
Benjamin J. J. McCormick ◽  
Laura E. Murray-Kolb ◽  
Pascal Bessong ◽  
Sanjaya K. Shrestha ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Cognitive Outcomes ◽  
Absolute Difference ◽  
Maternal Height ◽  
Z Score ◽  
Linear Regression Models ◽  
Poor Growth ◽  
Micronutrient Status

Abstract Background Poor growth in early childhood has been considered irreversible after 2–3 years of age and has been associated with morbidity and mortality over the short-term and with poor economic and cognitive outcomes over the long-term. The MAL-ED cohort study was performed in eight low-income settings with the goal of evaluating relationships between the child’s environment and experience (dietary, illness, and pathogen exposure, among others) and their growth and development. The goal of this analysis is to determine whether there are differences in the factors associated with growth from 24 to 60 months using two different metrics. Methods Across six MAL-ED sites, 942 children had anthropometry data at 24 and 60 months, as well as information about socioeconomic status, maternal height, gut permeability (lactulose-mannitol z-score (LMZ)), dietary intake from 9 to 24 months, and micronutrient status. Anthropometric changes were in height- or weight-for-age z-score (HAZ, WAZ), their absolute difference from the growth standard median (HAD (cm), WAD (kg)), as well as recovery from stunting/underweight. Outcomes were modeled using multivariate regression. Results At 24 months, almost half of the cohort was stunted (45%) and 21% were underweight. Among those who were stunted at 24 months (n = 426), 185 (43%) were no longer stunted at 60 months. Most children increased their HAZ from 24 to 60 months (81%), whereas fewer (33%) had positive changes in their HAD. Linear regression models indicate that girls improved less than boys from 24 to 60 months (HAZ: -0.21 (95% CI -0.27, -0.15); HAD: -0.75 (-1.07, -0.43)). Greater intestinal permeability (higher LMZ) at 0–24 months was associated with lower relative and absolute changes from 24 to 60 months (HAZ: -0.10 (-0.16, -0.04); HAD: -0.47 (-0.73, -0.21)). Maternal height (per 10 cm) was positively associated with changes (HAZ: 0.09 (0.03, 0.15); HAD: 0.45 (0.15, 0.75)). Similar relationships were identified for changes in WAZ and WAD. Conclusions The study children demonstrated improved growth from 24 to 60 months of age, but only a subset had positive changes in HAD and WAD. The same environmental factors were associated with growth from 24 to 60 months regardless of metric used (change in HAZ or HAD, or WAZ and WAD).

scholarly journals CTNI-01. EFFECT OF STEREOTACTIC RADIOSURGERY COMPARED TO WHOLE-BRAIN RADIOTHERAPY FOR LIMITED BRAIN METASTASIS ON LONG TERM COGNITION AND QUALITY OF LIFE: A POOLED ANALYSIS OF RANDOMIZED CLINICAL TRIALS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii40-ii41
Author(s):  
Joshua Palmer ◽  
Brett Klamer ◽  
Karla Ballman ◽  
Paul Brown ◽  
Jane Cerhan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Clinical Trials ◽  
Whole Brain Radiotherapy ◽  
Pooled Analysis ◽  
Cognitive Outcomes ◽  
Phase Iii ◽  
Brain Radiotherapy ◽  
Over Time

Abstract PURPOSE We investigated the long term impact of SRS and WBRT in two large prospective phase III trials. METHODS Patients with 1–4 BMs +/- resection were randomized to SRS or WBRT. Cognitive deterioration was a drop of >1 standard deviation from baseline in >2/6 cognitive measures (CM). Quality of life (QOL) scores were scored 0–100 point scale. CM and QOL scores were modeled using baseline adjusted Linear Mixed Models (LMM) with uncorrelated random intercept for subject and random slopes for time. Differences over time between groups and the effect of >2 cognitive scores with >2 SD change from baseline were assessed. RESULTS 88 patients were included with median follow up of 24 months. We observed decreasing CM over time (SRS: 4/6; WBRT: 5/6). Mean CM was significantly higher in SRS for Total recall and Delayed Recall at 3, 6, 9, 12 months. More patients in WBRT arm declined 1 SD in >1 and >2 CM at the 3, 6, 9, and 12 months. A 1 SD decline in >3 CM at 1 year was 21% SRS vs 47% WBRT (p=0.02). SRS had fewer patients with a 2 SD decline in >1 CM at every time point. SRS had fewer patients with a 2 SD decline at >2 and >3 CM. WBRT had lower QOL at 3 months, but switched to SRS having lower QOL at 24 months for PWB, EWB, FWB, FactG, BR, and FactBR (p< 0.05). A 2 SD decline in cognition decreased mean FWB by 6.4 units (95% CI: -11, -1.75; p=0.007) and decreased QOL by 5.1 units (95% CI: -7.7, -2.5; p< 0.001). CONCLUSIONS We report the first pooled prospective study demonstrating the long term outcomes of patients with BMs after cranial radiation. WBRT was associated with worse cognitive outcomes. Impaired cognition is associated with worse QOL.

Challenges during long-term follow-up of ICU patients with and without chronic disease

2016 ◽  
Vol 29 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Hugh Davies ◽  
Nicole McKenzie ◽  
Teresa A. Williams ◽  
Gavin D. Leslie ◽  
Ruth McConigley ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Icu Patients ◽  
Long Term Follow Up

Post-COVID impairment: objective multidimensional assessment of long term effects in hospitalized, non-ICU patients

2021 ◽  
Author(s):  
Emanuel Cardoso ◽  
Andrei Darie ◽  
Matthias Herrmann ◽  
Desiree M. Schumann ◽  
Leticia Grize ◽  
...  
Keyword(s):  
Long Term Effects ◽  
Icu Patients ◽  
Multidimensional Assessment

Potential Role of Adult Hippocampal Neurogenesis in Traumatic Brain Injury

2021 ◽  
Vol 28 ◽  
Author(s):  
Lucas Alexandre Santos Marzano ◽  
Fabyolla Lúcia Macedo de Castro ◽  
Caroline Amaral Machado ◽  
João Luís Vieira Monteiro de Barros ◽  
Thiago Macedo e Cordeiro ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Clinical Studies ◽  
Molecular Mechanisms ◽  
Hippocampal Neurogenesis ◽  
Cognitive Outcomes ◽  
Adult Hippocampal Neurogenesis ◽  
The Brain

: Traumatic brain injury (TBI) is a serious cause of disability and death among young and adult individuals, displaying complex pathophysiology including cellular and molecular mechanisms that are not fully elucidated. Many experimental and clinical studies investigated the potential relationship between TBI and the process by which neurons are formed in the brain, known as neurogenesis. Currently, there are no available treatments for TBI’s long-term consequences being the search for novel therapeutic targets, a goal of highest scientific and clinical priority. Some studies evaluated the benefits of treatments aimed at improving neurogenesis in TBI. In this scenario, herein, we reviewed current pre-clinical studies that evaluated different approaches to improving neurogenesis after TBI while achieving better cognitive outcomes, which may consist in interesting approaches for future treatments.

scholarly journals Quality of life of long term ICU patients at 6 months after hospital discharge

Critical Care ◽  
10.1186/cc295 ◽  
1998 ◽  
Vol 2 (Suppl 1) ◽  
pp. P166
Author(s):  
I Novák ◽  
V Šrámek ◽  
E Bokrová ◽  
M Bílek ◽  
M Matejovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Discharge ◽  
Icu Patients

scholarly journals Long-Term Cognitive Outcomes and Sleep in Adults After Extracorporeal Life Support

2021 ◽  
Vol 3 (4) ◽  
pp. e0390
Author(s):  
Marietou Daou ◽  
Claire Lauzon ◽  
E. Caroline Bullen ◽  
Irene Telias ◽  
Eddy Fan ◽  
...  
Keyword(s):  
Life Support ◽  
Extracorporeal Life Support ◽  
Cognitive Outcomes

Online Quality Control, Hyperfractionated Radiotherapy Alone and Reduced Boost Volume for Standard Risk Medulloblastoma: Long-Term Results of MSFOP 98

2009 ◽  
Vol 27 (11) ◽  
pp. 1879-1883 ◽  
Author(s):  
Christian Carrie ◽  
Jacques Grill ◽  
Dominique Figarella-Branger ◽  
Valerie Bernier ◽  
Laetitia Padovani ◽  
...  
Keyword(s):  
Overall Survival ◽  
Quality Control ◽  
Full Scale ◽  
Cognitive Outcomes ◽  
Long Term Results ◽  
Hyperfractionated Radiotherapy ◽  
Tumor Bed ◽  
Online Quality Control ◽  
Standard Risk

Purpose To determine event free and overall survival, and long-term cognitive sequelae of children with standard-risk medulloblastoma (SRM) treated with hyperfractionated radiotherapy, conformal reduced boost volume without chemotherapy, and online quality assurance. Patients and Methods Forty-eight patients (age 5 to 18 years) were included in the Medulloblastoma-Société Française d'Oncologie Pédiatrique (MSFOP 98) protocol (December 1998 to October 2001). Patients received hyperfractionated radiotherapy (HFRT; 36 Gy, 1 Gy/fraction twice per day) to the craniospinal axis followed by a boost to the tumor bed (1.5-cm margin) to a dose of 68 Gy. Records of craniospinal irradiation were reviewed before treatment started. Neuropsychologic evaluations were done according to the protocol (1, 3, 5, and 7 years after irradiation). Cognitive outcomes were followed longitudinally with full-scale intelligence quotient (FSIQ) obtained with age-adapted Wechsler scales. Results After a median follow-up of 77.7 months, 6-year overall survival (OS) and event-free survival (EFS) rates for the cohort were 78% (95% CI, 66% to 90%) and 75%, respectively (95% CI, 62% to 87%). Thanks to quality control, 14 major deviations were detected. Annual full scale IQ decline was 2 points over a 6-year period. Predicted change in FSIQ points per year was 2.15 (95% CI, −1.24 to 3.51) with an intercept (ie, predicted FSIQ) of 93.57 at baseline. Conclusion HFRT protocol with conformal reduced boost and online quality control allows excellent long-term OS and EFS in the absence of chemotherapy. In addition, FSIQ drops seem to be less pronounced than previously reported with standard irradiation regimens.

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