Postoperative cognitive dysfunction (POCD) is diagnosed in up to 30% patients after anaesthesia. The causative role of anaesthetic toxicity remains unclear. Using clinical tests, no clear-cut differences have been observed between anaesthetics so far. The aim of this trial was to compare the incidence of POCD diagnosed by a battery of neuropsychologic tests after propofol and sevoflurane anaesthesia. Secondary goal was to examine possible relationship between POCD positivity and changes in auditory event-related potentials (ERPs). Sixty patients undergoing lumbar discectomy were prospectively randomized to receive depth-controlled sevoflurane (SEVO) or propofol (PROP) based anaesthesia. The neuropsychological examination and auditory event-related potentials (N1, P3a and P3b components) recording was performed preoperatively and on days 1, 6 and 42 after surgery. POCD was defined as a decline of more than one standard deviation in three or more tests. In 43 patients (20 in PROP and 23 in SEVO group) all selected tests were performed and used for the evaluation. POCD was present in 48%/60%, 18%/20% and 17%/11% (SEVO/PROP) of patients on days 1, 6 and 42 after surgery, with no significant intergroup difference. Among neuropsychologic tests, the most significant decline was observed in Semantic Verbal Fluency and Letter-Number Sequencing Test scores, congruently in both groups on days 1 and 6, with full recovery on the last control. Transient deteriorations in other tests were observed as well. No association of POCD positivity and ERPs changes was found, although long-term modifications of P3a and P3b components were observed, mainly in SEVO group. In our study, sevoflurane and propofol anaesthesia was associated with the similar incidence of POCD. Cognitive decline, mainly affecting executive functions, was temporary in most of the patients. Prolonged ERPs alterations after the anaesthesia seem not to have any relationship with the impairment registered by the neuropsychological examination and may represent subclinical changes.

Propofol versus sevoflurane anaesthesia: effect on cognitive decline and event-related potentials

A review on Pb-bearing nanoparticles, particulate matter and colloids released from mining and smelting activities

In vitro bioaccessibility, phase partitioning, and health risk of potentially toxic elements in dust of an iron mining and industrial complex.

Postoperative cognitive dysfunction (POCD) is common, occurring in around 10-54% of individuals within first few weeks after surgery. Although the majority of POCD is less commonly persistent later than 3 months following surgery, the condition increases length of stay (LOS), mortality and long-term cognitive decline, raising the need for a broad screening to identify individuals at risk for POCD during the perioperative period. In this narrative review, we summarize preoperative, intraoperative and postoperative risk factors for POCD reported in last 5 years and discuss neuropsychological tools and potential biomarkers and time points for assessment that might be suitable for clinical use. We aim to provide crucial information for developing a strategy of routine screening for POCD, which may assist with better identification of at-risk individuals for early interventions. Very importantly, the utilization of a standardized strategy may also allow higher consistency and comparability across different studies.

https://journals.sagepub.com/doi/pdf/10.1177/17562864221114356

Identification of individuals at risk for postoperative cognitive dysfunction (POCD)

Africa accounts for nearly 30% of the discovered world’s mineral reserves, with half of the world’s platinum group metals deposits, 36% of gold, and 20% of cobalt being in Southern Africa (SA). The intensification of heavy-metal production in the SA region has exacerbated negative human and environmental health impacts. In recent years, mining waste generated from industrial and artisanal mining has significantly affected the ecological integrity of SA aquatic ecosystems due to the accelerated introduction and deposition of heavy metals. However, the extent to which heavy-metal pollution associated with mining has impacted the aquatic ecosystems has not been adequately documented, particularly during bioassessments. This review explores the current aquatic ecological impacts on the heavily mined river basins of SA. It also discusses the approaches to assessing the ecological risks, inherent challenges, and potential for developing an integrated ecological risk assessment protocol for aquatic systems in the region. Progress has been made in developing rapid bioassessment schemes (RBS) for SA aquatic ecosystems. Nevertheless, method integration, which also involves heavy-metal pollution monitoring and molecular technology, is necessary to overcome the current challenges of the standardisation of RBS protocols. Citizenry science will also encourage community and stakeholder involvement in sustainable environmental management in SA.

/pdf/aquatic-ecological-risk-of-heavy-metal-pollution-associated-1fcyz6xx.pdf

David Štěpánek

Papers

Slag dusts from Kabwe (Zambia): Contaminant mineralogy and oral bioaccessibility.

Cognitive impairment measured by event-related potentials during early and late postoperative period following intravenous or inhalation anaesthesia.