Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Patients undergoing major vascular surgery are at high risk of postoperative delirium and postoperative cognitive dysfunction (POCD). Apolipoprotein E (APOE) is involved in central acetylcholine synthesis, and patients bearing the ε4 genotype (APOE-ε4) are at increased risk of both vascular dementia and peripheral vascular disease. The purpose of this study was to evaluate the associations among delirium, POCD, and APOE-ε4 in patients undergoing open aortic repair. ⋯ Both delirium and POCD are common following open aortic repair; however, the APOE genotype did not predict either condition. This trial has been registered with ClinicalTrials.gov (NCT00911677).
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Clinical Trial
The clock drawing test is a poor screening tool for postoperative delirium and cognitive dysfunction after aortic repair.
The Clock Drawing Test (CDT) is a screening tool for dementia that tests a variety of cognitive domains. The CDT takes a maximum of two minutes to complete and might be helpful in identifying postoperative cognitive disorders at the bedside. The objective of this study was to evaluate the accuracy of the CDT in a population at high risk for postoperative cognitive disorders ⋯ Agreement between CDT and tests for delirium and POCD was poor; sensitivity was inadequate for a screening test. (ClinicalTrials.gov number, NCT00911677).
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Clinical Trial
The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia.
The radiological intercristal line (Tuffier's line) usually intersects the spine at the L4-L5 interspace. The intercristal line determined by palpation may be used erroneously as a surrogate for the true radiological Tuffier's line. We studied term pregnant women to establish the level at which a transverse line connecting the superior aspects of the iliac crests, as determined by palpation, intersects the lumbar spine, as assessed by ultrasound. ⋯ In pregnant women at term, the intercristal line determined by palpation does not correspond to the Tuffier's line determined radiologically, and it may intersect the spine at up to three interspaces higher.