Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cognitive difficulties after surgery are a common complication and are associated with significant morbidity and mortality, which is concerning as the number of geriatric patients undergoing major procedures continues to rise. Postoperative cognitive impairment encompasses both postoperative delirium and postoperative cognitive decline. Delirium is a formal diagnosis and presents acutely while postoperative cognitive decline has yet to be defined and has a subtle presentation. Postoperative cognitive decline is a decline in cognitive function from baseline and has been described in elderly patients after cardiac surgery, such as coronary artery bypass graft. Although the etiology of postoperative cognitive decline has yet to be elucidated, it is most likely multifactorial with potential causes being surgery type, sleep disturbances, neuroinflammation, cerebral hypoperfusion, anesthesia, metabolic syndrome, and decreased cognitive reserve. In this case report, we present the first case of postoperative cognitive decline in a middle-age patient after left ventricular assist device placement.
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PMID:A case of postoperative cognitive decline, with a highly elevated C- reactive protein, status post left ventricular assist device insertion: a review of the neuroinflammatory hypothesis of delirium. 2234 89

Traditionally, cognitive impairment has been associated not only with ageing itself but also with concomitant comorbidities that interact in the disease continuum from the prodromic phases. Notable among these are delirium, nutritional alterations, balance and gait, infections and even a progressive incidence of neoplasms. However, with regard to diagnosis and staging, clinicians should perhaps remain especially alert to the possibility of pharmacological iatrogeny, which is not limited to psychopharmacological treatment. Traditional risk factors for cognitive impairment and factors predictive of progression to dementia include hypertension, hyperglycaemia, hyperlipidaemia, smoking, alcohol, and metabolic syndrome. Emerging factors include atrial fibrillation, inflammation, hyperhomocysteinaemia, and heart failure. Paradoxically, prevention of risk factors such as hypotension, hypoglycaemia, bradycardia, low cardiac output and even malnutrition become more important at more advanced ages. Lastly, some cognitive variables such as memory, language and reading abilities, and some alterations in the affective sphere should also be assessed as predictive factors for mild cognitive impairment.
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PMID:[Disorders associated with mild cognitive impairment. Risk factors and predictors]. 2962 28

Clozapine is an atypical antipsychotic which is described to have higher efficacy among all available antipsychotic medications. Clozapine is reserved especially for resistant schizophrenia due to its side effects. Clozapine-induced metabolic syndrome and hyperglycaemia are common long-term side effects and are responsible for increased mortality in patients with schizophrenia. In this case, a patient with resistant schizophrenia was presented with acute-onset hyperglycaemia and delirium with the use of clozapine within a week. Withdrawal of clozapine in the patient led to the improvement in delirium and hyperglycaemia without the use of any hypoglycaemic agent. This case supports the notion that in certain cases clozapine can induce hyperglycemia through possible direct pathophysiological mechanisms within a shorter time frame.
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PMID:Acute onset clozapine-induced hyperglycaemia: A case report. 3117 33

The therapeutic potential of melatonin as a chronobiotic cytoprotective agent to counteract the consequences of COVID-19 infections has been advocated. Because of its wide-ranging effects as an antioxidant, anti-inflammatory, and immunomodulatory compound, melatonin could be unique in impairing the consequences of SARS-CoV-2 infection. Moreover, indirect evidence points out to a possible antiviral action of melatonin by interfering with SARS-CoV-2/angiotensin-converting enzyme 2 association. Melatonin is also an effective chronobiotic agent to reverse the circadian disruption of social isolation and to control delirium in severely affected patients. As a cytoprotector, melatonin serves to combat several comorbidities such as diabetes, metabolic syndrome, and ischemic and non-ischemic cardiovascular diseases, which aggravate COVID-19 disease. In view of evidence on the occurrence of neurological sequels in COVID-19-infected patients, another putative application of melatonin emerges based on its neuroprotective properties. Since melatonin is an effective means to control cognitive decay in minimal cognitive impairment, its therapeutic significance for the neurological sequels of SARS-CoV-2 infection should be considered. Finally, yet importantly, exogenous melatonin can be an adjuvant capable of augmenting the efficacy of anti-SARS-CoV-2 vaccines. We discuss in this review the experimental evidence suggesting that melatonin is a potential "silver bullet" in the COVID 19 pandemic.
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PMID:Can Melatonin Be a Potential "Silver Bullet" in Treating COVID-19 Patients? 3325 58