tetracycline and Cognition-Disorders

Postoperative cognitive dysfunction (POCD) is reported to occur frequently after all types especially cardiac surgery in elderly patients. It can be short-term or long-term and some cases even develop into Alzheimer's disease (AD). Although multi-risk factors associated with POCD have been identified, the etiology and pathophysiological mechanisms of this surgical complication remain elusive. Therefore, developing strategies for preventing or treating POCD is still challenging. However, increasing evidence suggests that central and systemic inflammation triggered by surgery likely plays a fundamental role in POCD developing and progression. Minocycline, a tetracycline derivative with anti-inflammatory properties, has been shown to be effective in treating neuroinflammatory related conditions or neurodegenerative diseases such as AD, Parkinson's disease, Huntington's disease. Considering that inflammation may be a potential factor of POCD and minocycline is effective in improving cognitive dysfunction induced by inflammation, we hypothesize that minocycline may be useful to treat/prevent the POCD development after surgery in elderly patients.

Topics: Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Brain Diseases; Cognition Disorders; Humans; Inflammation; Minocycline; Models, Theoretical; Neurodegenerative Diseases; Postoperative Complications; Sepsis; Tetracycline; Treatment Outcome

Three consecutive cases of Whipple's disease observed by us in recent years have involved neurologic symptoms, i.e. psychoorganic syndromes, gaze palsy, nystagmus, masseteric and pharyngeal myoclonus or papilledema. In one case mononuclear cells in the cerebrospinal fluid, most probably of ependymal origin, were loaded with periodic-acid-Schiff (PAS) positive granules. On treatment with antibiotics the neurologic signs cleared considerably or completely. The findings suggest (a) that neurologic involvement Whipple's disease may not be so uncommon as appears from the literature, (b) that examination of the spinal fluid with PAS staining may be helpful in the diagnosis of such cases, and (c) that neurologic involvement in Whipple's disease may also be amenable to treatment with antibiotics.

Topics: Adult; Aged; Cerebrospinal Fluid; Chloramphenicol; Cognition Disorders; Eye Manifestations; Humans; Male; Masticatory Muscles; Myoclonus; Neurologic Manifestations; Papilledema; Penicillins; Streptomycin; Tetracycline; Whipple Disease

Topics: Brain Abscess; Cerebral Ventricles; Clostridium perfringens; Cognition Disorders; Gas Gangrene; Hemiplegia; Humans; Injections; Male; Middle Aged; Otitis Media; Penicillins; Radiography; Reflex, Stretch; Streptomycin; Tetracycline