Olga Yu. Shchelkova

Background. Coronary artery bypass grafting (CABG) has been one of the most performed surgical procedures for more than 30 years. Recent research has shown severe cognitive disorders accompanying cardiac surgery. However, mild cognitive dysfunction, which is more amenable to prevention and correction, has been less studied because of difficulties in diagnosing it. 

Objective. For this reason, we set out to analyze the dynamics of cognitive functioning in CHD patients undergoing CABG. Our study focuses on the main indicators of cognitive functioning and on comparing cognitive functioning with normative data, as well as on the emotional state which accompanies cardiac surgery. 

Methods. The present study enrolled 70 patients (of average age 59.71 ± 7.32 years) who underwent CABG with the standard cardiopulmonary bypass technique. Our examination used a pathopsychological test battery (including the WAIS, TMT, Stroop test, TAS, Benton test, etc.), and was performed in three stages: two days before, and both 12–14 days and three months after the surgery. 

Results. The results obtained suggest that the majority of cognitive complaints are connected with memory decline after CABG. Patients with CHD experience significant postoperative cognitive decline mostly in verbal memory and attention. A significant cognitive improvement three months after the operation occurred in the following cognitive domains: visual memory, logical memory, and spatial thinking. An analysis of the patients’ trait anxiety leads to the conclusion that the highest intensity of anxiety was observed in relation to the following indicators: “emotional discomfort,” “asthenic component,” and “anxious assessment of the future.” 

Conclusion. Our research demonstrates negative changes in both short- and longterm memory. Possible reasons for postoperative cognitive decline include the conditions and consequences of the surgery, normal aging, brain injury at the time of coronary surgery, and the emotional state of the patients. A positive trend was discovered in the visual and logical memory, active attention, and thinking activity.

The study aimed to investigate the basic aspects of quality of life and relation to disease in patients with malignant or premalignant bone tumors. Study participants (N=82) were aged 18 to 67 years (average age 34 ± 2 years). They were separated into three groups depending on diagnosis: patients with osteosarcoma, patients with giant cell tumor and patients with chondrosarcoma. The SF-36 Health Status Survey and the Quality of Life Questionnaire - Core 30 with Bone Metastasis (BM22) Module were used to assess patient quality of life. The type of relation to disease method (TOBOL) was used to determine the relation to disease of the patients.

According to the results of the quality of life study, patients with giant cell tumor exhibited the highest degree of limiting physical activity and reduced social functioning, the greatest financial difficulties and more pain sites than either patients with osteosarcoma or patients with chondrosarcoma. The study of relation to disease revealed that all studied groups of patients were susceptible to ergopathic and sensitive types of relation to disease. Moreover, patients with giant cell tumor experienced increased levels of tension and irritability with respect to relation to disease and treatment, while patients with chondrosarcoma were more susceptible to anxiety and hypochondria with respect to relation to disease.

Patients with different types of bone tumors have different experiences with respect to their physical and mental health, their social functioning and their general health. The results of the study may be useful in developing individualized psychological aid programs for patients with malignant and premalignant bone tumors.