scholarly journals Comparison of the Effects of Hypothermia and Normothermia on Cognitive Functions After Coronary Artery Bypass Surgery

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohsen Ziyaeifard ◽  
Alireza Ghavidel ◽  
Abbas Moradi ◽  
Mostafa Fatahi ◽  
AmirHosein Salehzadeh ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Functions ◽  
Significant Relationship ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Moderating Factors ◽  
Hospitalization Period ◽  
History Of ◽  
Normothermic Group ◽  
Hypothermic Group

Background: Cognitive impairment is among the most prevalent complications in patients undergoing CABG. Selection of the proper temperature is one of the main moderating factors in cognitive impairment following CABG. Today, heart surgery is done using the two methods of hypothermia and normothermia. However, there is no consensus over the method with the least side effects. Objectives: This study aims to compare the effects of hypothermia and normothermia on cognitive functions after undergoing CABG during the hospitalization period. Methods: A total of 130 patients in this cohort observational study were divided into two groups of normothermic (n = 65) and hypothermic (n = 65). In the hypothermic group, the temperature was down to 32°C, and in the normothermic group, the temperature decreased to 35°C. After the surgery and transferring the patients to the ICU, demographic information and MMSE questionnaires were completed from the second to the sixth day at the same time. Results: The results showed no significant differences between the two groups in educational and social demographic characteristics (P > 0.05). Besides, there was no significant differences between the two groups in the history of the disease (P = 1.000). In addition, there was no significant relationship between cognitive performance scores of the two groups before the surgery (P = 1.000). However, there was a significant relationship between the two groups from the second (P = 0.003), third (P = 0.000) and the fourth day (P = 0.023) after the surgery. In the normothermic group, on the second, as well as third and fourth days 14 and 9 patients suffered from cognitive impairment, respectively. Besides, in the hypothermic group, on the second, third, and fourth days after surgery, 28, 30, and 23 patients suffered from cognitive impairment, respectively. However, there was no significant relationship between the two groups on the fifth and sixth days after the surgery (P = 0.079). Conclusions: The present study showed that during hospitalization after undergoing CABG, cognitive impairment in patients with the normothermic method was less severe than that in patients with the hypothermic method. Besides, clinical outcomes were more satisfactory in the former group.

scholarly journals COVID-19 and Cognitive Impairment: A Cross-Sectional Clinic Based Study

2021 ◽  
Author(s):  
Amira Siddig ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Ahmed Abdelrahman ◽  
AlHussien Abbasher ◽  
Abubaker Alsedig Abbasher ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Functions ◽  
Age Distribution ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Senior Consultant ◽  
Presenting Symptoms ◽  
Phonemic Fluency ◽  
History Of

Abstract Background: Patients with dementia are more prone to acquire COVID-19 infection. Patients with COVID-19 showed a tendency to develop cognitive impairment. Objectives: We aimed to study the clinical manifestations of COVID-19 infection among adult Sudanese demented patients and the prevalence of cognitive impairment among adult Sudanese non demented patients. Methodology: This is a descriptive cross-sectional study which took place in Sudan, Khartoum state in the period (September-December 2021) in a private neurology/psychiatry clinic. 135 adult Sudanese patients were included in this study and were divided into two groups. The first group consists of 100 patients with a known history of dementia that got infected recently with COVID-19, while the second group consists of 35 patients who developed some sort of cognitive impairment after recovering from COVID-19 infection. Regarding the second group, cognitive functions were assessed by senior consultant neurologist and senior consultant psychiatrist using a well validated neuropsychological measure. Results: Out of 100 patients in the first group, females were 60 and males were 40. Age distribution is between 63 -98. The common presenting symptoms of COVID-19 among this group were: Cough and fever (90 patients), diarrhea and vomiting (5 patients), breathlessness (4 patients), coughing of blood (5 patients), convulsions (1 patient), paraplegia (1 patient) and hemiplegia (1 patient). Regarding the second group, Age distribution varied from 30 to 80 years. Cognitive functions impairment was noticed as follows: Memory recall (22%), memory recognition (23%), memory encoding (24%), processing speed (16%), executive functioning (19%), phonemic fluency (17%) and category fluency (17%). Conclusion: Patients with dementia are more susceptible to develop COVID-19 infection. Patients with COVID-19 Infection are at risk of developing some sort of cognitive impairment after recovery.

scholarly journals Sex characteristics of cognitive functions assessed by the MMSE and MoCA scores in patients with coronary artery disease

2021 ◽  
Vol 26 (2) ◽  
pp. 4194
Author(s):  
I. V. Tarasova ◽  
O. A. Trubnikova ◽  
A. S. Sosnina ◽  
I. D. Syrova ◽  
I. N. Kukhareva ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Coronary Artery ◽  
Cognitive Functions ◽  
Verbal Fluency ◽  
Clinical Laboratory ◽  
Mmse Score ◽  
Artery Bypass ◽  
Cognitive Status ◽  
Sex Characteristics ◽  
Severe Cognitive Impairment

Aim. To study the sex characteristics of cognitive functions in a cohort of patients undergoing coronary artery bypass grafting (CABG) by comparing the results of Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores.Material and methods. The prospective cohort study included 272 people, including 74 women aged 41 to 82 years, who were admitted to the Research Institute of Complex Issues of Cardiovascular Diseases for CABG surgery. All patients underwent clinical, laboratory, electrophysiological and ultrasound examinations. The Charlson comorbidity index (CCI) was calculated. Assessment of cognitive functions was carried out using the MMSE and MoCA scores. All types of statistical analysis were performed using the STATISTICA 10 program (StatSoft Inc., USA).Results. It was found that women scheduled for CABG have an older age and a higher CCI score compared to men (p=0,008). According to the MMSE, the likelihood of moderate and severe cognitive impairment in men compared with women was 1,36 times higher (odds ratio (OR), 1,35; 95% confidence interval (CI), 0,79-2,32, Z=1,11, p=0,27). The MoCA scores showed that half of the male (49%) and female (50%) participants had severe cognitive impairment. The likelihood of moderateand severe cognitive impairment in men compared with women was 1,33 times higher (OR, 1,33; 95% CI, 0,68-2,59, Z=0,841, p=0,40). According to subtests of the MoCA, men were better in naming (p=0,002), abstraction (p=0,005), and women outperformed men in verbal fluency (p=0,04). Regression analysis revealed that the most significant negative predictors for cognitive status as measured by the MMSE and MoCA scores for men and women were age and CCI.Conclusion. Women scheduled for CABG, having the worst clinical and demographic indicators, are comparable with men in cognitive status using the MMSE score. The MoCA score shows sex differences in naming, abstraction, and verbal fluency domains and revealed a higher percentage of severe cognitive disorders (up to 50%) compared to the MMSE score (7-9%). In male and female candidates for CABG, age and comorbidities are negatively associated with cognitive status.

scholarly journals Open Heart Surgery at Patient’s Own Temperature Without Active Cooling

2018 ◽  
Vol 21 (3) ◽  
pp. 132
Author(s):  
Mehmet Kaplan ◽  
Anil Karaagac ◽  
Tolga Can ◽  
Sahin Yilmaz ◽  
Mehmet Inanc Yesilkaya ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Body Temperature ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Serum Lactate ◽  
Active Cooling ◽  
Transfusion Requirements ◽  
Significant Difference ◽  
Normothermic Group ◽  
Hypothermic Group

Background: Hypothermia is a method of myocardial protection in cardiac surgery. This protection occurs by decreasing the metabolic demands, however, it creates susceptibility to various problems. In this study, we investigated patients operated on under normothermia (at the patient’s own temperature) and hypothermia for postoperative differences.Methods: The study was conducted between June 2015 and September 2016 with 167 patients. The patients were divided into two groups in accordance with our routine clinical practice: the normothermic group (native temperature goup; intraoperative body temperature ≥ 34°C), and the hypothermic group intraoperative body temperature  < 34°C - ≥ 28°C). Preoperative and postoperative data of patients were recorded and the two groups were compared.Results: There was no significant difference between the two groups in terms of cross clamp time, cardiopulmonary bypass time, awakening and extubation times, intensive care unit and hospital stay, drainage, mean serum lactate levels, arrhytmia, all causes infection, renal insufficiency, neurologic complications, myocardial infarction, or mortality (P > .05). Inotrope and transfusion requirements were found to be statistically significantly lower in the normothermic group than the hypothermic group (P < .05).Conclusion: Although hypothermia is commonly used in cardiac surgery, it has harmful effects. We believe that cardiac surgery can safely be performed at a patient’s own temperature without active cooling to avoid these dangers.

scholarly journals Cognitive impairment in recipients of liver transplantation and relation to hepatic encephalopathy

2022 ◽  
Vol 29 (1) ◽  
Author(s):  
Ahmad Saad Mohamed ◽  
Mahmoud Ahmed Elmeteini ◽  
Ghada Abd Elrazek Mohamed ◽  
Doha Mostafa Elserafy ◽  
Alaa Adel Elmadani ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Cognitive Impairment ◽  
Hepatic Encephalopathy ◽  
Cognitive Functions ◽  
Digit Span ◽  
Organ Transplant ◽  
Trail Making Test ◽  
Significant Difference ◽  
History Of ◽  
Trail Making

Abstract Background Liver transplantation (LT) helped to save the life of end stage liver disease (ESLD) patients; however, there is a debate on the persistence of cognitive impairment. The study aimed to evaluate cognitive functions in patients with ESLD before and after liver transplantation and to assess its relation to hepatic encephalopathy (HE). Thirty recipients 47.6 ± 11 years undergone living donor liver transplantation at the transplantation center of both Ain Shams Center for Organ Transplant and Egypt air organ transplant unit were prospectively assessed by Trail Making Test, Wechsler Memory Scale–Revised, Benton Visual Retention—for the evaluation of cognitive functions before and 3 months after transplantation. Results The mean age of the patients was 47.6 ± 11 years, 17 males and 13 females. Eight out of 30 (26.7%) had past history of hepatic encephalopathy. The study reported significant improvement in the post-operative 3 months scores of Trail Making Test part (A), the digit span forward test, digit span backward test and the correct score difference of the Benton Visual Retention, as p value was (0.02), (0.01) (0.02), and (0.01) respectively, compared to the pre-operative scores. However, there was no difference in the scores of part (B), verbal association I, II, information subtest of WMS. Cognitive performance showed no significant difference between patients with or without history of HE. Conclusions Patients with ESLD have significant cognitive impairment that showed improvement after LT; HE did not correlate with cognitive function. Hence, transplantation has a favorable outcome on the cognitive impairment.

Comparison of Normothermic Cardiopulmonary Bypass with Conventional Hypothermic Bypass

1997 ◽  
Vol 5 (4) ◽  
pp. 199-202
Author(s):  
Sandeep Chauhan ◽  
Gaurishankar Ramesh ◽  
Nita Saxena ◽  
Shiv Kumar Choudhary ◽  
Lokendra Kumar ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Heart Surgery ◽  
Sinus Node ◽  
Open Heart Surgery ◽  
Postoperative Blood Loss ◽  
Arterial Blood ◽  
Early Return ◽  
Normothermic Group ◽  
Hypothermic Group

In a prospective randomized study from October to December 1996 at the All India Institute of Medical Sciences, we compared normothermic cardiopulmonary bypass with conventional hypothermic bypass. Sixty patients undergoing open-heart surgery for valvular heart disorders were assigned to undergo either normothermic bypass (35°C to 37°C, n = 30) or moderate hypothermic bypass (28°C, n = 30). Bypass time, pump flow, urine output, need for vasopressors, arterial blood gases on bypass, duration of cardioplegia, need for defibrillation, postoperative blood loss, rewarming time to a peripheral (toe) temperature above 35°C, awakening time, and neurologic outcome were studied. Mean bypass time in the normothermic patients (67.33 ± 23.5 minutes) was 23% less (p < 0.05) than in the hypothermic group (89.6 ± 49.26 minutes). Higher flows were required initially in the normothermic group due to low systemic vascular resistance. Early return of sinus node electrical activity in patients (70%) in the normothermic group required more frequent use of topical ice slush and cardioplegia administration. Postoperative blood loss was similar in both groups but fluid and blood requirements in the normothermic group (514 ± 220 mL·m−2) was significantly less (p < 0.05) than in the hypothermic group (722.3 ± 383 mLm−2). Normothermic patients rewarmed earlier (4.25 ± 1.79 hours) to peripheral (toe) temperatures above 35 °C and awoke earlier compared with the hypothermic group, which took a mean time of 6.1 ± 2.3 hours to rewarm. We concluded that normothermic bypass is more physiologic and significantly reduces bypass time while avoiding the deleterious effects of hypothermia.

Language processing is not a race against time

2016 ◽  
Vol 39 ◽  
Author(s):  
Giosuè Baggio ◽  
Carmelo M. Vicario
Keyword(s):  
Information Processing ◽  
Human Brain ◽  
Language Processing ◽  
Cognitive Functions ◽  
Memory Systems ◽  
Language System ◽  
Moderating Factors

AbstractWe agree with Christiansen & Chater (C&C) that language processing and acquisition are tightly constrained by the limits of sensory and memory systems. However, the human brain supports a range of cognitive functions that mitigate the effects of information processing bottlenecks. The language system is partly organised around these moderating factors, not just around restrictions on storage and computation.

Enhanced Vocational Rehabilitation: A Pilot for Veterans With Cognitive Impairment and a History of Mild TBI

2012 ◽  
Author(s):  
Maureen K. O'Connor ◽  
Lisa Mueller ◽  
Alicia Semiatin ◽  
Charles E. Drebing ◽  
Shihwe Wang
Keyword(s):  
Cognitive Impairment ◽  
Vocational Rehabilitation ◽  
Mild Tbi ◽  
History Of
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