Structural and functional characterisation of the dextran utilisome from Bacteroides thetaiotaomicron.

Postoperative delirium (POD) is an acute cognitive dysfunction commonly observed in elderly surgical patients, characterized by disturbances in consciousness, attention deficits, and cognitive changes. The reported incidence of POD varies widely depending on surgical procedures and assessment tools, with particularly high rates documented in orthopedic populations., POD is associated with prolonged hospitalization, increased morbidity and mortality, and long-term cognitive impairment, underscoring the need for effective preventive strategies., Various strategies have been explored for POD prevention. Multicomponent non‑pharmacological interventions—including early mobilization, reorientation, and sleep hygiene—have been shown to reduce delirium in older surgical patients. Pharmacologically, several agents have been investigated. A recent network meta‑analysis of 158 trials identified dexmedetomidine, corticosteroids, melatonin receptor agonists, parecoxib, olanzapine, and intranasal insulin as the most effective interventions. Among these, dexmedetomidine has emerged as a particularly attractive candidate due to its unique sedative profile and opioid‑sparing effects. Dexmedetomidine, a highly selective α-adrenergic receptor agonist, offers several perioperative advantages over traditional sedatives. Unlike propofol, which acts on Gamma-Aminobutyric Acid (GABA) receptors, dexmedetomidine exerts sedative effects without direct GABAergic interference, potentially resulting in a more favorable cognitive profile. Additionally, dexmedetomidine induces sedation resembling natural sleep, which may mitigate postoperative sleep deprivation and circadian rhythm disruption—both recognized risk factors for delirium.,