Effects on Cognition of Conventional and Robotically Assisted Cardiac Valve Operation

Bruce, Kathryn; Yelland, Gregory Wayne; Almeida, Aubrey; Smith, Julian Anderson; Robinson, Stephen R.

doi:10.1016/j.athoracsur.2013.07.018

Cited by 8 publications

(2 citation statements)

References 14 publications

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“…The SCIT has been employed with a range of populations, including the elderly, children with developmental disorders, human immunodeficiency virus-1 immunopositive individuals, cardiac surgery patients, and individuals who have been sleep-deprived or are intoxicated. 16 , 18 – 21 While the primary advantage of the SCIT is its rapid administration time (3 minutes compared with 15–120 minutes for other computerized measures of global cognitive function), other advantages include a lack of cultural or sex bias and lack of a learning effect that enables the SCIT to be used repeatedly without any loss of reliability.…”

Section: Introductionmentioning

confidence: 99%

Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly

Bruce¹,

Robinson²,

Smith³

et al. 2014

CIA

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The present study tested 121 middle-aged and elderly community-dwelling individuals on the computer-based Subtle Cognitive Impairment Test (SCIT) and compared their performance with that on several neuropsychological tests. The SCIT had excellent internal consistency, as demonstrated by a high split-half reliability measure (0.88–0.93). Performance on the SCIT was unaffected by the confounding factors of sex, education level, and mood state. Many participants demonstrated impaired performance on one or more of the neuropsychological tests (Controlled Oral Word Association Task, Rey Auditory and Verbal Learning Task, Grooved Pegboard [GP], Complex Figures). Performance on SCIT subtests correlated significantly with performance on many of the neuropsychological subtests, and the best and worst performing quartiles on the SCIT subtest discriminated between good and poor performers on other subtests, collectively indicating concurrent validity of the SCIT. Principal components analysis indicated that SCIT performance does not cluster with performance on most of the other cognitive tests, and instead is associated with decision-making efficacy, and processing speed and efficiency. Thus, the SCIT is responsive to the processes that underpin multiple cognitive domains, rather than being specific for a single domain. Since the SCIT is quick and easy to administer, and is well tolerated by the elderly, it may have utility as a screening tool for detecting cognitive impairment in middle-aged and elderly populations.

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Section: Introductionmentioning

confidence: 99%

Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly

Bruce¹,

Robinson²,

Smith³

et al. 2014

CIA

View full text Add to dashboard Cite

show abstract

“…Some have utility for the detection of minor cognitive impairments generally. One such test is the Subtle Cognitive Impairment Test (SCIT, http://neurotest.com/), a very short (3–5 min), computer‐based, perceptual judgement task that has been found to be sensitive to very small differences in global cognitive performance across a wide range of clinical and non‐clinical populations . It is a reliable and valid measure that has no practice effects .…”

mentioning

confidence: 99%

Gluten‐induced cognitive impairment (“brain fog”) in coeliac disease

Yelland

2017

J of Gastro and Hepatol

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Much is known about the serious neurological effects of gluten ingestion in coeliac disease patients, such as sporadic ataxia and peripheral neuropathy, although the causal links to gluten are still under debate. However, such disorders are observed in only a small percentage of coeliac patients. Much less is known about the transient cognitive impairments to memory, attention, executive function, and the speed of cognitive processing reported by the majority of patients with coeliac disease. These mild degradations of cognitive functions, referred to as "brain fog," are yet to be formally recognized as a medical or psychological condition. However, subtle tests of cognitive function are measurable in untreated patients with coeliac disease and improve over the first 12 months' therapy with a gluten-free diet. Such deficits also occur in patients with Crohn's disease, particularly in association with systemic inflammatory activity. Thus, cognitive impairments associated with brain fog are psychologically and neurologically real and improve with adherence to a gluten-free diet. There is not yet sufficient evidence to provide a definitive account of the mechanism by which gluten ingestion causes the impairments to cognitive function associated with brain fog, but current evidence suggests that it is more likely that the causal factor is not directly related to exposure to gluten.Coeliac disease (CD) is an inflammatory autoimmune reaction to gluten ingestion causing small bowel damage, for which the only existing treatment is a gluten-free diet (GFD). The intestinal lesions are defined by varying degrees of villous atrophy and intraepithelial lymphocytosis. However, the consequences of CD are not restricted to the intestinal tract. It is a systemic inflammatory disease that impacts the brain and neural system in at least two ways: major (or gross) neurological disorders and "silent" neurological complaints. While the prevalence of gluten-related major neurological disorders is very low, it is where the bulk of empirical research has been focused. However, little attention has been paid to the silent neurological consequences of gluten ingestion in CD and yet it would appear that its behavioral consequences, "brain fog," are considerably more prevalent.The major neurological complications of CD are identifiable neurological disorders where there are clear patterns of neural and behavioral dysfunctions that have serious impact on the life of the patients. Gluten ataxia is a disorder of the central nervous system, a specifically gluten-related cerebellar atrophy that results in a lack of coordination of complex movements like walking, speaking, and swallowing.1 Peripheral neuropathy is consequence of inflammation in peripheral nerve fibers, which variously impairs sensation (sensory nerves), movement (motor nerves), or gland or organ function (autonomic nerves).2 There is increasing evidence that untreated CD could result in severe and degenerative loss of global cognitive function, in particular loss of memor...

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Limited versus full sternotomy for aortic valve replacement

Kirmani

Jones

Malaisrie

et al. 2017

Cochrane Database of Systematic Reviews

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The evidence in this review was assessed as generally low to moderate quality. The study sample sizes were small and underpowered to demonstrate differences in outcomes with low event rates. Clinical heterogeneity both between and within studies is a relatively fixed feature of surgical trials, and this also contributed to the need for caution in interpreting results.Considering these limitations, there was uncertainty of the effect on mortality or extracorporeal support times with upper hemi-sternotomy for aortic valve replacement compared to full median sternotomy. The evidence to support a reduction in total hospital length of stay or intensive care stay was low in quality. There was also uncertainty of any difference in the rates of other, secondary outcome measures or adverse events with minimally invasive limited sternotomy approaches to aortic valve replacement.There appears to be uncertainty between minimally invasive aortic valve replacement via upper hemi-sternotomy and conventional aortic valve replacement via a full median sternotomy. Before widespread adoption of the minimally invasive approach can be recommended, there is a need for a well-designed and adequately powered prospective randomised controlled trial. Such a study would benefit from performing a robust cost analysis. Growing patient preference for minimally invasive techniques merits thorough quality-of-life analyses to be included as end points, as well as quantitative measures of physiological reserve.

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Effects on Cognition of Conventional and Robotically Assisted Cardiac Valve Operation

Cited by 8 publications

References 14 publications

Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly

Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly

Gluten‐induced cognitive impairment (“brain fog”) in coeliac disease

Limited versus full sternotomy for aortic valve replacement

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