Data suggest bypass surgery free of long-term brain effects 
Author Message
 Data suggest bypass surgery free of long-term brain effects

Public release date: 25-Apr-2005
 [ Print Article | E-mail Article  | Close Window ]

 Contact: David Greenberg

 201-748-6484
John Wiley & Sons, Inc.

Data suggest bypass surgery free of long-term brain effects

 A broad retrospective review of the effects of coronary artery bypass
grafting (CABG) on memory and other brain functions concludes that,
while there may be transient short-term effects, the procedure itself
probably does not cause late or permanent neurological effects.

In an article published online April 25, 2005, in the Annals of
Neurology (www.interscience.wiley.com/journal/ana), the authors argue
that the late cognitive declines seen in some long-term studies are
likely associated with progression of underlying conditions such as
cerebrovascular disease rather than the surgery itself.

"We think that there are short-term cognitive changes after CABG in a
subset of patients, but absent a frank stroke, these changes are
generally mild and transient," said author Ola Selnes, Ph.D., professor
of neurology at Johns Hopkins Hospital in Baltimore, Maryland. "We
believe most patients who experience cognitive decline will return to
their baseline by three months or sooner."

The exceptions, according to Selnes, might include older patients and
those with risk factors for cerebrovascular disease or a history of
stroke.

In their review article, Selnes and co-author Guy M. McKhann, M.D., also
of Johns Hopkins, surveyed the published studies on cognitive changes
following CABG. Confusing the issue, they point out, is the variability
in the way this question has been approached.

Selnes and McKhann note that the surgical procedure itself varies among
different institutions and surgeons. Similarly, there is wide variance
in study populations and control groups, follow-up periods, and
statistical analysis.

It is curious, the authors note, that studies should continue to find
cognitive deficits despite the fact that CABG is a procedure in
evolution, with surgical and anesthesiological techniques improving
vastly over the past decades. This may be due in part to the reality
that the population having the surgery is becoming older and sicker,
with more hypertension, diabetes, previous strokes, and other disorders.

"In this paper, we reassessed what we think we know about cognitive
decline attributable to the use of cardiopulmonary bypass versus
cognitive decline due to pre-existing vascular disease of the brain,"
said Selnes. "Just about everyone agrees that some patients do suffer
cognitive decline after CABG, but almost nobody agrees on how serious
this decline is, and how long it lasts."

The authors find that the existing literature confirms the existence of
mild deficits in the period up to three months after surgery, possibly
due to minor disruption in {*filter*} flow that can be result from any major
surgery, or other factors associated with surgery such as inflammation
or complications of anesthesia.

But when they looked closely at the most authoritative studies -- those
with appropriate control groups -- the authors failed to find strong
evidence that cognitive deficits persist after three months in most
patients.

"We believe that patients should not be discouraged from having CABG
because of the risk of late cognitive decline," said Selnes.

He adds that their review emphasizes the need to have an appropriate
control group when looking at cognitive outcomes after a surgical
procedure.

###

Article: "Neurocognitive Complications after Coronary Artery Bypass
Surgery," Ola A. Selnes and Guy M. McKhann, Annals of Neurology;
Published Online: April 25, 2005 (DOI: 10.1002/ana.20481)

The Annals of Neurology, the preeminent neurological journal worldwide,
is published by the American Neurological Association, the world's
oldest and most prestigious neurological association. The 1,500 members
of the ANA--selected from among the most respected academic neurologists
and neuroscientists in North America and other countries--are devoted to
furthering the understanding and treatment of nervous system disorders.
For more information, visit www.aneuroa.org.

--
Zone 5 S Jersey USA Shade garden in a Jungle Japanese manner
Vision problems? http://www.***.com/
 "oeuf t?t pique " Lover  39.615557 N, 75.04088 W



Fri, 12 Oct 2007 19:21:52 GMT
 Data suggest bypass surgery free of long-term brain effects
  Perhaps I will have to find another excuse;)))

Bill

..............................
Public release date: 25-Apr-2005
 [ Print Article | E-mail Article  | Close Window ]

 Contact: David Greenberg

 201-748-6484
John Wiley & Sons, Inc.

Data suggest bypass surgery free of long-term brain effects

 A broad retrospective review of the effects of coronary artery bypass
grafting (CABG) on memory and other brain functions concludes that,
while there may be transient short-term effects, the procedure itself
probably does not cause late or permanent neurological effects.

In an article published online April 25, 2005, in the Annals of
Neurology (www.interscience.wiley.com/journal/ana), the authors argue
that the late cognitive declines seen in some long-term studies are
likely associated with progression of underlying conditions such as
cerebrovascular disease rather than the surgery itself.

"We think that there are short-term cognitive changes after CABG in a
subset of patients, but absent a frank stroke, these changes are
generally mild and transient," said author Ola Selnes, Ph.D., professor
of neurology at Johns Hopkins Hospital in Baltimore, Maryland. "We
believe most patients who experience cognitive decline will return to
their baseline by three months or sooner."

The exceptions, according to Selnes, might include older patients and
those with risk factors for cerebrovascular disease or a history of
stroke.

In their review article, Selnes and co-author Guy M. McKhann, M.D., also
of Johns Hopkins, surveyed the published studies on cognitive changes
following CABG. Confusing the issue, they point out, is the variability
in the way this question has been approached.

Selnes and McKhann note that the surgical procedure itself varies among
different institutions and surgeons. Similarly, there is wide variance
in study populations and control groups, follow-up periods, and
statistical analysis.

It is curious, the authors note, that studies should continue to find
cognitive deficits despite the fact that CABG is a procedure in
evolution, with surgical and anesthesiological techniques improving
vastly over the past decades. This may be due in part to the reality
that the population having the surgery is becoming older and sicker,
with more hypertension, diabetes, previous strokes, and other disorders.

"In this paper, we reassessed what we think we know about cognitive
decline attributable to the use of cardiopulmonary bypass versus
cognitive decline due to pre-existing vascular disease of the brain,"
said Selnes. "Just about everyone agrees that some patients do suffer
cognitive decline after CABG, but almost nobody agrees on how serious
this decline is, and how long it lasts."

The authors find that the existing literature confirms the existence of
mild deficits in the period up to three months after surgery, possibly
due to minor disruption in {*filter*} flow that can be result from any major
surgery, or other factors associated with surgery such as inflammation
or complications of anesthesia.

But when they looked closely at the most authoritative studies -- those
with appropriate control groups -- the authors failed to find strong
evidence that cognitive deficits persist after three months in most
patients.

"We believe that patients should not be discouraged from having CABG
because of the risk of late cognitive decline," said Selnes.

He adds that their review emphasizes the need to have an appropriate
control group when looking at cognitive outcomes after a surgical
procedure.

###

Article: "Neurocognitive Complications after Coronary Artery Bypass
Surgery," Ola A. Selnes and Guy M. McKhann, Annals of Neurology;
Published Online: April 25, 2005 (DOI: 10.1002/ana.20481)

The Annals of Neurology, the preeminent neurological journal worldwide,
is published by the American Neurological Association, the world's
oldest and most prestigious neurological association. The 1,500 members
of the ANA--selected from among the most respected academic neurologists
and neuroscientists in North America and other countries--are devoted to
furthering the understanding and treatment of nervous system disorders.
For more information, visit www.aneuroa.org.

?

--
Zone 5 S Jersey USA Shade garden in a Jungle Japanese manner
Vision problems? http://www.***.com/
 "oeuf t?t pique " Lover  39.615557 N, 75.04088 W



Fri, 12 Oct 2007 22:23:27 GMT
 Data suggest bypass surgery free of long-term brain effects
Now I will have to find another excuse.  Third post    Sorry.

Implications???  Meds  may require more scrutiny.

Bill

Public release date: 25-Apr-2005
 [ Print Article | E-mail Article  | Close Window ]

 Contact: David Greenberg

 201-748-6484
John Wiley & Sons, Inc.

Data suggest bypass surgery free of long-term brain effects

 A broad retrospective review of the effects of coronary artery bypass
grafting (CABG) on memory and other brain functions concludes that,
while there may be transient short-term effects, the procedure itself
probably does not cause late or permanent neurological effects.

In an article published online April 25, 2005, in the Annals of
Neurology (www.interscience.wiley.com/journal/ana), the authors argue
that the late cognitive declines seen in some long-term studies are
likely associated with progression of underlying conditions such as
cerebrovascular disease rather than the surgery itself.

"We think that there are short-term cognitive changes after CABG in a
subset of patients, but absent a frank stroke, these changes are
generally mild and transient," said author Ola Selnes, Ph.D., professor
of neurology at Johns Hopkins Hospital in Baltimore, Maryland. "We
believe most patients who experience cognitive decline will return to
their baseline by three months or sooner."

The exceptions, according to Selnes, might include older patients and
those with risk factors for cerebrovascular disease or a history of
stroke.

In their review article, Selnes and co-author Guy M. McKhann, M.D., also
of Johns Hopkins, surveyed the published studies on cognitive changes
following CABG. Confusing the issue, they point out, is the variability
in the way this question has been approached.

Selnes and McKhann note that the surgical procedure itself varies among
different institutions and surgeons. Similarly, there is wide variance
in study populations and control groups, follow-up periods, and
statistical analysis.

It is curious, the authors note, that studies should continue to find
cognitive deficits despite the fact that CABG is a procedure in
evolution, with surgical and anesthesiological techniques improving
vastly over the past decades. This may be due in part to the reality
that the population having the surgery is becoming older and sicker,
with more hypertension, diabetes, previous strokes, and other disorders.

"In this paper, we reassessed what we think we know about cognitive
decline attributable to the use of cardiopulmonary bypass versus
cognitive decline due to pre-existing vascular disease of the brain,"
said Selnes. "Just about everyone agrees that some patients do suffer
cognitive decline after CABG, but almost nobody agrees on how serious
this decline is, and how long it lasts."

The authors find that the existing literature confirms the existence of
mild deficits in the period up to three months after surgery, possibly
due to minor disruption in {*filter*} flow that can be result from any major
surgery, or other factors associated with surgery such as inflammation
or complications of anesthesia.

But when they looked closely at the most authoritative studies -- those
with appropriate control groups -- the authors failed to find strong
evidence that cognitive deficits persist after three months in most
patients.

"We believe that patients should not be discouraged from having CABG
because of the risk of late cognitive decline," said Selnes.

He adds that their review emphasizes the need to have an appropriate
control group when looking at cognitive outcomes after a surgical
procedure.

###

Article: "Neurocognitive Complications after Coronary Artery Bypass
Surgery," Ola A. Selnes and Guy M. McKhann, Annals of Neurology;
Published Online: April 25, 2005 (DOI: 10.1002/ana.20481)

The Annals of Neurology, the preeminent neurological journal worldwide,
is published by the American Neurological Association, the world's
oldest and most prestigious neurological association. The 1,500 members
of the ANA--selected from among the most respected academic neurologists
and neuroscientists in North America and other countries--are devoted to
furthering the understanding and treatment of nervous system disorders.
For more information, visit www.aneuroa.org.

?

--
Zone 5 S Jersey USA Shade garden in a Jungle Japanese manner
Vision problems? http://www.***.com/
 "oeuf t?t pique " Lover  39.615557 N, 75.04088 W



Sat, 13 Oct 2007 04:23:56 GMT
 
 [ 3 post ] 

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