POCD

POCD
  • 文章类型: Systematic Review
    由于不断扩大的人口,对新型医疗保健治疗和药物的需求增加了。检测新的疾病,和迫在眉睫的流行病。纳米技术的发展为尖端的体内非侵入性监测和即时检测(POCT)提供了一个平台,用于康复疾病的检测和管理。纳米生物传感器的进步和用途目前在各种科学领域变得越来越普遍,如环境监测,食品安全,生物医学,临床,和可持续医疗保健科学,自从纳米技术出现以来。近年来,通过利用有关生物传感器和纳米生物传感器的纳米技术的几种传感技术,可以识别和检测与任何类型的疾病(可传播或非传播)有关的生物模式。在这项工作中,通过使用系统审查和荟萃分析(PRISMA)技术的首选报告项目,从六个数字数据库中抽取和筛选了2218篇文章,其中17篇入围了本次审查。因此,这项研究使用了系统的方法来回顾一些最近开发的极其敏感的纳米生物传感器,以及他们的生物医学,即时诊断(POCD),或医疗保健应用程序及其功能,特别是根据一些最新出版物对一些致命疾病的预测。纳米生物传感器的潜在药用,治疗性的,或其他可持续医疗应用,特别是对疾病的诊断,也被认为是未来趋势的体现。
    The need for novel healthcare treatments and drugs has increased due to the expanding human population, detection of newer diseases, and looming pandemics. The development of nanotechnology offers a platform for cutting-edge in vivo non-invasive monitoring and point-of-care-testing (POCT) for rehabilitative disease detection and management. The advancement and uses of nanobiosensors are currently becoming more common in a variety of scientific fields, such as environmental monitoring, food safety, biomedical, clinical, and sustainable healthcare sciences, since the advent of nanotechnology. The identification and detection of biological patterns connected to any type of disease (communicable or not) have been made possible in recent years by several sensing techniques utilizing nanotechnology concerning biosensors and nanobiosensors. In this work, 2218 articles are drawn and screened from six digital databases out of which 17 were shortlisted for this review by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) technique. As a result, this study uses a systematic methodology to review some recently developed extremely sensitive nanobiosensors, along with their biomedical, point-of-care diagnostics (POCD), or healthcare applications and their capabilities, particularly for the prediction of some fatal diseases based on a few of the most recent publications. The potential of nanobiosensors for medicinal, therapeutic, or other sustainable healthcare applications, notably for ailments diagnostics, is also recognized as a way forward in the manifestation of future trends.
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  • 文章类型: Journal Article
    术后认知功能障碍(POCD)越来越被认为是术后并发症的原因。一个共识工作组建议将POCD区分为认知恢复延迟,ie,术后30天进行评估,和神经认知障碍,ie,在手术后30天至12个月之间进行评估。此外,麻醉剂的选择,吸入或全静脉麻醉(TIVA)及其对POCD发生率的影响,已成为研究的重点。我们的主要目的是搜索文献并进行荟萃分析,以验证全身麻醉的选择是否会影响术后前30天POCD的发生率。作为次要目标,我们对文献进行了系统回顾,以评估麻醉对术后30天至12个月POCD的影响.对于主要目标,对1913篇文章的初步审查产生了10项研究,共3390人.对于次要目标,共纳入4项研究,共480例患者.术后前30天,TIVA组POCD的比值比为0.46(95%CI=0.26-0.81;p=0.01),与吸入组相比。术后前30天TIVA与POCD发生率较低相关。关于次要目标,由于精选文章数量少,异质性高,没有进行元分析。鉴于POCD标准的异质性,未来应进行更稳健设计的前瞻性研究,以充分解决这一问题.
    Postoperative cognitive dysfunction (POCD) has been increasingly recognized as a contributor to postoperative complications. A consensus-working group recommended that POCD should be distinguished between delayed cognitive recovery, ie, evaluations up to 30 days postoperative, and neurocognitive disorder, ie, assessments performed between 30 days and 12 months after surgery. Additionally, the choice of the anesthetic, either inhalational or total intravenous anesthesia (TIVA) and its effect on the incidence of POCD, has become a focus of research. Our primary objective was to search the literature and conduct a meta-analysis to verify whether the choice of general anesthesia may impact the incidence of POCD in the first 30 days postoperatively. As a secondary objective, a systematic review of the literature was conducted to estimate the effects of the anesthetic on POCD between 30 days and 12 months postoperative. For the primary objective, an initial review of 1913 articles yielded ten studies with a total of 3390 individuals. For the secondary objective, four studies with a total of 480 patients were selected. In the first 30 days postoperative, the odds-ratio for POCD in TIVA group was 0.46 (95% CI = 0.26-0.81; p = 0.01), compared to the inhalational group. TIVA was associated with a lower incidence of POCD in the first 30 days postoperatively. Regarding the secondary objective, due to the small number of selected articles and its high heterogeneity, a metanalysis was not conducted. Given the heterogeneity of criteria for POCD, future prospective studies with more robust designs should be performed to fully address this question.
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  • 文章类型: Journal Article
    OBJECTIVE: To clarify whether intraoperative hypotension contributes to the development of postoperative cognitive dysfunction.
    METHODS: A systematic review of prospective studies reporting on intraoperative hypotension and postoperative cognitive dysfunction in elective, non-cognitive impaired, adult surgical patients. PubMed, EMBASE and the Cochrane Library were searched up to the 1st of January 2021.
    METHODS: Studies had to use a clear definition of hypotension, although differing definitions were accepted. Neurocognitive tests to determine postoperative cognitive dysfunction had to be done pre- and postoperatively, with a minimum follow-up of seven days postoperatively.
    METHODS: Risk of bias was assessed using the Cochrane Risk of Bias Tool 2.0 for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies.
    RESULTS: Out of 941 studies screened, five randomized controlled trials and four cohort studies were included for qualitative analysis. Extensive methodological differences between studies were present hindering proper quantitive analysis. No studies reported statistically significant differences in incidence of postoperative cognitive dysfunction in hypo- compared to normotensive patients. Five studies reported exact incidences of postoperative cognitive dysfunction.
    CONCLUSIONS: This systematic review showed no conclusive association between intraoperative hypotension and the development of postoperative cognitive dysfunction. Given the vast methodological differences of the included studies, the role of intraoperative hypotension in the development of postoperative cognitive dysfunction remains uncertain. Future research into the association between intraoperative hypotension and postoperative cognitive dysfunction should be conducted in a standardized manner.
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  • 文章类型: Journal Article
    Postoperative Cognitive Dysfunction (POCD) refers to the condition of neurocognitive decline following surgery in a cognitive and sensory manner. There are several risk factors, which may be life-threatening for this condition. Neuropsychological assessment of this condition is very important. In the present review, we discuss the association of apolipoprotein epsilon 4 (APOE ε4) and few miRNAs with POCD, and highlight the clinical importance for prognosis, diagnosis and treatment of POCD. Microarray is a genome analysis that can be used to determine DNA abnormalities. This current technique is rapid, efficient and high-throughout. Microarray techniques are widely used to diagnose diseases, particularly in genetic disorder, chromosomal abnormalities, mutations, infectious diseases and disease-relevant biomarkers. MicroRNAs (miRNAs) are a class of non-coding RNAs that are widely found distributed in eukaryotes. Few miRNAs influence the nervous system development, and nerve damage repair. Microarray approach can be utilized to understand the miRNAs involved and their pathways in POCD development, unleashing their potential to be considered as a diagnostic marker for POCD. This paper summarizes and identifies the studies that use microarray based approaches for POCD analysis. Since the application of microarray in POCD is expanding, there is a need to review the current knowledge of this approach.
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  • 文章类型: Journal Article
    BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs frequently after major surgery. Hypertension is well-established as a risk factor for age-related cognitive impairment, but it is unclear whether or not it also increases the risk of POCD.
    OBJECTIVE: To evaluate the role of hypertension in POCD risk in a systematic review and meta-analysis.
    METHODS: PubMed, Ovid SP and the Cochrane Database of Systematic Reviews were searched for longitudinal studies of adults undergoing surgery with reporting of hypertension, blood pressure and/or anti-hypertensive treatment associations with POCD as relative risks or odds ratios. Fixed-effects meta-analyses were performed using Review Manager (version 5.3).
    RESULTS: Twenty-four studies on 4317 patients (mean age 63 years) were included. None of the studies had set out to assess hypertension as a risk factor for POCD. Hypertension was used as a categorical predictor throughout and only 2 studies adjusted for potential confounders. Across all 24 studies, hypertension was not significantly associated with POCD risk (RR 1.01; 95% CI 0.93, 1.09; p=0.82), though among 8 studies with >75% males, we found hypertension associations with a 27% increased risk of POCD (RR 1.27, 95% CI 1.07, 1.49; p=0.005).
    CONCLUSIONS: Our findings do not support the hypothesis that hypertension is a risk factor for POCD. However, since none of the studies included in our analysis were hypothesis-driven and most did not adjust for potential confounders, further systematic investigations are needed to evaluate the role of hypertension in the epidemiology of POCD.
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  • 文章类型: Journal Article
    Post-operative cognitive dysfunction, a condition distinct from post-operative delirium (POD), occurs frequently after surgery, and is related to dementia and premature death. Obesity increases the risk of late-life cognitive impairment, but little is known about its role in post-operative cognitive dysfunction. We conducted a systematic review and meta-analysis of studies on the association between obesity and risk of post-operative cognitive dysfunction.
    PubMed and the Cochrane Library were systematically searched. Studies were included if they had prospective designs, reported on human adults undergoing surgery, if cognitive function was measured pre- and post-surgery, if obesity, body mass index (BMI) and/or body weight were ascertained, and if associations with post-operative cognitive dysfunction were reported as relative risks or odds ratios. Underweight, weight loss, and post-operative delirium were not considered.
    Inclusion criteria were met by six articles. Samples totaled 1432 older patients (mean age ≥62 years) who were followed up for 24 h to 12 months after surgery. Analysis of studies with obesity defined as a categorical measure found a non-significantly higher risk of post-operative cognitive dysfunction among persons with BMI > 30 kg/m(2) versus ≤30 kg/m(2) (relative risk 1.27; 95% confidence interval 0.95, 1.70; p = 0.10). No such associations were found for studies that analysed BMI or body weight continuously as predictors of post-operative cognitive dysfunction (relative risk 0.98 per kg/m(2) ; 95% confidence interval 0.93, 1.03, p = 0.45; relative risk 0.99 per kg; 95% confidence interval 0.89, 1.09; p = 0.83, respectively).
    Few studies have addressed the topic, and the results of these studies provide only limited support for an increased risk of post-operative cognitive dysfunction in patients who are obese. Further large-scale, prospective investigations are necessary for clarification. Copyright © 2016 John Wiley & Sons, Ltd.
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  • 文章类型: Journal Article
    Exposure to surgery and general anesthesia (GA) has been hypothesized to be a potential risk factor for the development of Alzheimer\'s disease (AD). Some basic science research studies have demonstrated AD pathology in animals following exposure to inhalational anesthetics. However, controversy exists as to whether GA is associated with an elevated risk of developing AD in human populations. While randomized controlled clinical trials would provide the strongest evidence for a causal relationship between exposure to surgery under GA and the subsequent development of AD, to date there have not been any trials to address this important question. Therefore, a potential relationship between GA and AD must currently be examined using observational methods. A recent meta-analysis of case-control studies (N = 15) did not find that AD was associated with prior exposure to GA (OR = 1.05, 95% CI: 0.93-1.19, p = 0.4). A limited number of retrospective cohort studies have likewise not provided definitive information supporting an association. Therefore, at the present time there is limited information to support the hypothesis of AD developing as a consequence of GA, although there are few high quality studies in this area. Given the high prevalence and impact of AD, and the relatively frequent exposure of large populations to surgical procedures, the association between AD and GA requires further study.
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