Search

The inability to accurately predict the occurrence of postoperative cognitive dysfunction (POCD) among open-heart surgery patients leads to concerning increases in POCD cases. Preoperative circulating biomarkers are important to identify as they are non-invasive and could provide an early prediction of POCD development, allowing for earlier and more strategized interventions. However, to date, no robust circulating biomarkers have proven effective for preoperative POCD prediction. This systematic review aims to synthesize current evidence on preoperative protein profiling among POCD patients following open-heart surgery. Thus, a thorough literature search employing PubMed, EBSCOhost, Scopus, and Science Direct was carried out. This combination of keywords was used as part of the search strategy: ("Postoperative cognitive decline" OR "Postoperative cognitive disorders" OR "Postoperative cognitive dysfunction" OR "Postoperative cognitive complications") AND ("Thoracic Surgery" OR "Cardiac Surgery" OR "Heart Surgery") AND ("Protein expression" OR proteomic OR "Protein profiling"). Eight hundred and twenty-nine studies were retrieved and only clinical studies reporting the circulating preoperative differentially expressed Proteins (DEPs) in the POCD patients were selected. Six studies were selected following the inclusion and exclusion criteria. Only one preoperative DEP and four immediate postoperative DEPs were extracted from the studies. All four proteins were selected for analysis using DAVID, STRING, and Cytoscape software. Due to the very low number of proteins, no clusters have been identified. This systematic review demonstrates the lack of POCD preoperative biomarkers for open-heart-surgery patients. Thus, it is suggested that more studies can be conducted to fill this gap. [ABSTRACT FROM AUTHOR]

Background: Mini-mental State Examination (MMSE) is widely accepted clinically for postoperative cognitive dysfunction (POCD) assessment. This study aims to investigate the post-operative cognitive changes among high-risk cardiothoracic patients and establish a standardised approach to post-surgery cognitive assessment. Methods: This is a prospective cohort study, where cognitive assessments were done 1-day before surgery, at discharge, and during 6 weeks of follow-up. Sample size calculation, accounting for an estimated 20% dropout rate, determined a minimum of 170 subjects were required for the study. Reduction of MMSE score of more than 2.5 was considered as having POCD. Score differences between groups were analysed using T-test and analysis of variance (ANOVA), while consistency between tools was analysed using correlation and regression. Results: A total of 188 patients completed the study, with a POCD prevalence of 20.2% and 6.9% at discharge and at the 6 week follow up, respectively. All cognitive tools show a significant difference between preoperative and postoperative scores. All tests show a significant moderate correlation with MMSE. Conclusions: In conclusion, it is imperative to employ a battery of cognitive assessments to evaluate cognitive changes comprehensively. [ABSTRACT FROM AUTHOR]

Background/Objectives: Nutritional status significantly influences cardiac surgery outcomes, with malnutrition contributing to poorer results and increased complications. This study addresses the critical gap in understanding by exploring the relationship between pre-operative nutritional status and post-operative cognitive dysfunction (POCD) in adult cardiac patients. Methods: A comprehensive search across key databases investigates the prevalence of malnutrition in pre-operative cardiac surgery patients, its effects, and its association with POCD. Factors exacerbating malnutrition, such as chronic illnesses and reduced functionality, are considered. The study also examines the incidence of POCD, its primary association with CABG procedures, and the impact of malnutrition on complications like inflammation, pulmonary and cardiac failure, and renal injury. Discussions: Findings reveal that 46.4% of pre-operative cardiac surgery patients experience malnutrition, linked to chronic illnesses and reduced functionality. Malnutrition significantly contributes to inflammation and complications, including POCD, with an incidence ranging from 15 to 50%. CABG procedures are particularly associated with POCD, and malnutrition prolongs intensive care stays while increasing vulnerability to surgical stress. Conclusions: The review underscores the crucial role of nutrition in recovery and advocates for a universally recognized nutrition assessment tool tailored to diverse cardiac surgery patients. Emphasizing pre-operative enhanced nutrition as a potential strategy to mitigate inflammation and improve cognitive function, the review highlights the need for integrating nutrition screening into clinical practice to optimize outcomes for high-risk cardiac surgery patients. However, to date, most data came from observational studies; hence, there is a need for future interventional studies to test the hypothesis that pre-operative enhanced nutrition can mitigate inflammation and improve cognitive function in this patient population. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the protective effects of edible bird nest (EBN) against the detrimental impact of Wi‐Fi on male reproductive health. Specifically, it examines whether EBN can mitigate Wi‐Fi‐induced changes in male reproductive hormones, estrogen receptors (ER), spermatogenesis, and sperm parameters. Methods: Thirty‐six adult male rats were divided into six groups (n = 6): Control, Control EBN, Control E2, Wi‐Fi, Wi‐Fi+EBN, and Wi‐Fi+E2. Control EBN and Wi‐Fi+EBN groups received 250 mg/kg/day EBN, while Control E2 and Wi‐Fi+E2 groups received 12 μg/kg/day E2 for 10 days. Wi‐Fi exposure and EBN supplementation lasted eight weeks. Assessments included organ weight, hormone levels (FSH, LH, testosterone, and E2), ERα/ERβ mRNA and protein expression, spermatogenic markers (c‐KIT and SCF), and sperm quality. Results: Wi‐Fi exposure led to decreased FSH, testosterone, ERα mRNA, and sperm quality (concentration, motility, and viability). EBN supplementation restored serum FSH and testosterone levels, increased serum LH levels, and the testosterone/E2 ratio, and normalized mRNA ERα expression. Additionally, EBN increased sperm concentration in Wi‐Fi‐exposed rats without affecting motility or viability. Conclusions: EBN plays a crucial role in regulating male reproductive hormones and spermatogenesis, leading to improved sperm concentration. This could notably benefit men experiencing oligospermia due to excessive Wi‐Fi exposure. [ABSTRACT FROM AUTHOR]

Background: Mini-mental State Examination (MMSE) is widely accepted clinically for postoperative cognitive dysfunction (POCD) assessment. This study aims to investigate the post-operative cognitive changes among high-risk cardiothoracic patients and establish a standardised approach to post-surgery cognitive assessment., Methods: This is a prospective cohort study, where cognitive assessments were done 1-day before surgery, at discharge, and during 6 weeks of follow-up. Sample size calculation, accounting for an estimated 20% dropout rate, determined a minimum of 170 subjects were required for the study. Reduction of MMSE score of more than 2.5 was considered as having POCD. Score differences between groups were analysed using T -test and analysis of variance (ANOVA), while consistency between tools was analysed using correlation and regression., Results: A total of 188 patients completed the study, with a POCD prevalence of 20.2% and 6.9% at discharge and at the 6 week follow up, respectively. All cognitive tools show a significant difference between preoperative and postoperative scores. All tests show a significant moderate correlation with MMSE., Conclusions: In conclusion, it is imperative to employ a battery of cognitive assessments to evaluate cognitive changes comprehensively., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 The Author(s). Published by IMR Press.)