Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar
Vesna Jevtovic-Todorovic,Anthony Absalom,Klas Blomgren,Ansgar M. Brambrink,G. Crosby,Deborah J. Culley,Gary Fiskum,Rona G. Giffard,Karl F. Herold,Andreas W. Loepke,Daqing Ma,Beverley A. Orser,Emmanuel Planel,W. Slikker,Sulpicio G. Soriano,G. Stratmann,Laszlo Vutskits,Zhongcong Xie,Hugh C. Hemmings +18 more
TLDR
mounting evidence from preclinical studies reveals general anaesthetics to be powerful modulators of neuronal development and function, which could contribute to detrimental behavioural outcomes, however, definitive clinical data remain elusive.Abstract:
Although previously considered entirely reversible, general anaesthesia is now being viewed as a potentially significant risk to cognitive performance at both extremes of age. A large body of preclinical as well as some retrospective clinical evidence suggest that exposure to general anaesthesia could be detrimental to cognitive development in young subjects, and might also contribute to accelerated cognitive decline in the elderly. A group of experts in anaesthetic neuropharmacology and neurotoxicity convened in Salzburg, Austria for the BJA Salzburg Seminar on Anaesthetic Neurotoxicity and Neuroplasticity. This focused workshop was sponsored by the British Journal of Anaesthesia to review and critically assess currently available evidence from animal and human studies, and to consider the direction of future research. It was concluded that mounting evidence from preclinical studies reveals general anaesthetics to be powerful modulators of neuronal development and function, which could contribute to detrimental behavioural outcomes. However, definitive clinical data remain elusive. Since general anaesthesia often cannot be avoided regardless of patient age, it is important to understand the complex mechanisms and effects involved in anaesthesia-induced neurotoxicity, and to develop strategies for avoiding or limiting potential brain injury through evidence-based approaches.read more
Citations
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Challenges in paediatric procedural sedation: political, economic, and clinical aspects
TL;DR: This review highlights the important contributions to paediatric sedation over the past century and considers the barriers and politics that impede progress and also future advances and contributions that may lie ahead.
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Isoflurane reversibly destabilizes hippocampal dendritic spines by an actin-dependent mechanism.
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Radiophobia: 7 Reasons Why Radiography Used in Spine and Posture Rehabilitation Should Not Be Feared or Avoided.
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Advanced second year fellowship training in pediatric anesthesiology in the United States.
Dean B. Andropoulos,Scott G. Walker,Scott G. Walker,C. Dean Kurth,C. Dean Kurth,Randall M. Clark,Randall M. Clark,Desmond B. Henry +7 more
TL;DR: The purpose of this article is to present the work of this task force and the recommendations for an optional Second Year Advanced Pediatric Anesthesiology Fellowship, and to communicate these recommendations to stakeholders within and outside the subspecialty.
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Death of the ALARA Radiation Protection Principle as Used in the Medical Sector.
Paul A. Oakley,Deed E. Harrison +1 more
TL;DR: The ALARA principle, as used as a radiation protection principle throughout medicine, is scientifically defunct and should be abandoned.
References
More filters
Journal ArticleDOI
The classical complement cascade mediates CNS synapse elimination.
Beth Stevens,Nicola J. Allen,Luis E. Vazquez,Gareth R. Howell,Karen S. Christopherson,Navid Nouri,Kristina D. Micheva,Adrienne K. Mehalow,Andrew D. Huberman,Benjamin K. Stafford,Alexander Sher,Alan Litke,John D. Lambris,Stephen J. Smith,Simon W. M. John,Ben A. Barres +15 more
TL;DR: It is shown that C1q, the initiating protein in the classical complement cascade, is expressed by postnatal neurons in response to immature astrocytes and is localized to synapses throughout the postnatal CNS and retina, supporting a model in which unwanted synapses are tagged by complement for elimination and suggesting that complement-mediated synapse elimination may become aberrantly reactivated in neurodegenerative disease.
Journal ArticleDOI
Comparative aspects of the brain growth spurt
John Dobbing,Jean Sands +1 more
TL;DR: The brain in all species appears to grow through a sigmoid trajectory when its weight is plotted against its age, but the timing of the brain growth spurt is different in relation to birth in different species, so this must be one of the major factors to be taken into account when any attempt is made to extrapolate results obtained in one species to any other.
Journal ArticleDOI
Excitatory actions of gaba during development: the nature of the nurture.
TL;DR: This work proposes that GABA becomes inhibitory by the delayed expression of a chloride exporter, leading to a negative shift in the reversal potential for choride ions, and provides a solution to the problem of how to excite developing neurons to promote growth and synapse formation.
Journal ArticleDOI
Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study
J. T. Moller,Pjm Pierre Cluitmans,Lars S. Rasmussen,Peter J. Houx,H Rasmussen,Jaume Canet,Patrick Rabbitt,Jellemer Jolles,K. Larsen,CD Hanning,Olivier Langeron,T Johnson,PM Lauven,P A Kristensen,A Biedler,H van Beem,O Fraidakis,Jeffrey H. Silverstein,Jew Jan Beneken,JS Gravenstein +19 more
TL;DR: The findings of this international multicentre study have implications for studies of the causes of cognitive decline and, in clinical practice, for the information given to patients before surgery.
Journal ArticleDOI
Reducing Endogenous Tau Ameliorates Amyloid ß-Induced Deficits in an Alzheimer's Disease Mouse Model
Erik D. Roberson,Kimberly Scearce-Levie,Jorge J. Palop,Fengrong Yan,Irene H. Cheng,Tiffany Wu,Hilary Gerstein,Gui Qiu Yu,Lennart Mucke +8 more
TL;DR: Reducing endogenous tau levels prevented behavioral deficits in transgenic mice expressing human amyloid precursor protein, without altering their high Aβ levels, and protected both transgenic and nontransgenic mice against excitotoxicity.
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