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trauma insulin

Ozlem Korkmaz Dilmen, Ercument Yentur, Yusuf Tunali, Huriye Balci, Mois Bahar
OBJECTIVES: Surgical trauma produces metabolic and hormonal responses, which are characterized by insulin resistance. Due to extension of the preoperative fasting period, which increases the magnitude of postoperative insulin resistance, preoperative oral carbohydrates (POC) have been developed. PATIENTS AND METHODS: This prospective, randomized, controlled study was performed on 43 ASA I-II patients undergoing elective microsurgical lumbar discectomy. The intervention group received oral carbohydrate solution 800mL the night before and 400mL 2h prior to operation...
December 29, 2016: Clinical Neurology and Neurosurgery
Anke Delie, Philip Vlummens, David Creytens, Eva Steel
We present a case of cutaneous mucormycosis in a patient with several important risk factors precipitating disease, namely underlying acute myeloid leukaemia and poorly controlled secondary diabetes. Inoculation was most likely caused by repeated minor trauma (insulin injection) at the site of infection. Treatment consisted of surgical debridement and liposomal Amphotericin B (LAmB) during 71 days. Posaconazole had already been initiated prior to infection as primary antifungal prophylaxis but was discontinued during follow-up as susceptibility testing later revealed resistance to posaconazole...
December 26, 2016: Acta Clinica Belgica
Anca Chiriac, Irina Costache, Cristian Podoleanu, Adrian Naznean, Simona Stolnicu
Bullosis diabeticorum (BD), or diabetic bulla, is 1 of the cutaneous manifestations of diabetes mellitus, reported in 0.5% of people with diabeties in the United States, mostly in adult men who have had long-lasting and uncontrolled diabetes associated with diabetic peripheral neuropathy. However, BD in young children is a mostly unrecognized entity. We present a case of BD in a 3-year-old girl with type 1 diabetes mellitus who had been treated with insulin for 7 months prior to hospitalization. Dermatologic examination revealed a large, tense bulla filled with clear fluid and not associated with pain or pruritus, localized on the lateral margin of the right hand...
December 21, 2016: Canadian Journal of Diabetes
Rui-Cheng Zhang, Ying-Feng Mu, Jing Dong, Xiao-Qian Lin, De-Qin Geng
Pituitary adenoma apoplexy is a well-known clinical syndrome induced by insulin infusion, cardiac surgery, trauma, and hypothalamic releasing factors. Pituitary apoplexy can cause secondary cerebral infarct and internal carotid artery occlusion. With blockade of tumor perfusion, apoplexy triggers a sudden onset of headache, visual impairment, cranial nerve palsy, disturbances of consciousness, eyelid ptosis, and hemiparesis. However, pituitary adenoma cells with high metabolic demand cannot survive with deficient blood supply and glucose concentrations...
January 1, 2017: Reviews in the Neurosciences
L Taali, M Abou-Elfadl, M Fassih, M Mahtar
INTRODUCTION: Nasal NK/T-cell lymphoma is a rare clinicopathological entity, formerly called midline lethal granuloma. Following progress in histology and the routine use of immunohistochemistry, nasal NK/T-cell lymphoma was recognized as a distinct entity by WHO in 2001. CASE REPORT: The authors report the case of a 22-year-old, insulin-dependent diabetic woman, who presented with mid-facial inflammatory swelling following facial trauma, initially diagnosed and treated as cellulitis of the face...
October 24, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Kuan-Ho Lin, Chien-Liang Liu, Wei-Wen Kuo, Catherine Reena Paul, Wei-Kung Chen, Su-Ying Wen, Cecilia Hsuan Day, Hsi-Chin Wu, Vijaya Padma Viswanadha, Chih-Yang Huang
Cardiac trauma has been recognized as a complication associated with blunt chest trauma involving coronary artery injury, myocardium contusion and myocardial rupture. Secondary cardiac injuries after trauma supposed to be a critical factor in trauma patients, but the mechanism is not fully explored. Overproduction of TNF-alpha had been reported in multiple trauma animals, this induces oxidative stress resulting in cardiac apoptosis. Apoptosis gradually increases after trauma and reaches to a maximum level in 12 h time...
2016: PloS One
Matthew P Rowan, Darrick J Beckman, Julie A Rizzo, Claire L Isbell, Christopher E White, Stephen M Cohn, Kevin K Chung
BACKGROUND: Burn and trauma patients present a clinical challenge due to metabolic derangements and hypermetabolism that result in a prolonged catabolic state with impaired healing and secondary complications, including ventilator dependence. Previous work has shown that circulating levels of growth hormone (GH) are predictive of mortality in critically ill adults, but few studies have examined the prognostic potential of GH levels in adult trauma patients. METHODS: To investigate the utility of GH and other endocrine responses in the prediction of outcomes, we conducted a prospective, observational study of adult burn and trauma patients...
October 4, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Hakan Aylanç, Filiz Tütüncüler, Necdet Süt
BACKGROUND: This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma. MATERIALS AND METHODS: In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined...
October 2016: Journal of Neurosciences in Rural Practice
Sarah H Koning, Klaas Hoogenberg, Kirsten A Scheuneman, Mick G Baas, Fleurisca J Korteweg, Krystyna M Sollie, Bertine J Schering, Aren J van Loon, Bruce H R Wolffenbuttel, Paul P van den Berg, Helen L Lutgers
BACKGROUND: To evaluate the neonatal and obstetric outcomes of pregnancies complicated by gestational diabetes mellitus (GDM). Screening and treatment - diet-only versus additional insulin therapy - were based on the 2010 national Dutch guidelines. METHODS: Retrospective study of the electronic medical files of 820 singleton GDM pregnancies treated between January 2011 and September 2014 in a university and non-university hospital. Pregnancy outcomes were compared between regular care treatment regimens -diet-only versus additional insulin therapy- and pregnancy outcomes of the Northern region of the Netherlands served as a reference population...
September 29, 2016: BMC Endocrine Disorders
Emin Ozbek, Alper Otunctemur, Suleyman Sahin, Levent Ozcan, Murat Dursun, Emrecan Polat, Feti Tulubas, Mustafa Cekmen
OBJECTIVE: SUI, involuntary loss of urine, occurs when intra abdominal pressure exceeds urethral pressure in women. Recent animal study has shown that there are therapeutic effects of Insulin-like growth factors (IGF-1) on stress urinary incontinence in rats with simulated childbirth trauma. IGF-1 is an important mediator of cell growth, differentiation and transformation in various tissues and stimulates fibroblast proliferation and enhances collagen synthesis. The purpose of the current study was to determine the association between IGF-1 levels and SUI...
July 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Derek T Musashe, Maria D Purice, Sean D Speese, Johnna Doherty, Mary A Logan
Neuronal injury triggers robust responses from glial cells, including altered gene expression and enhanced phagocytic activity to ensure prompt removal of damaged neurons. The molecular underpinnings of glial responses to trauma remain unclear. Here, we find that the evolutionarily conserved insulin-like signaling (ILS) pathway promotes glial phagocytic clearance of degenerating axons in adult Drosophila. We find that the insulin-like receptor (InR) and downstream effector Akt1 are acutely activated in local ensheathing glia after axotomy and are required for proper clearance of axonal debris...
August 16, 2016: Cell Reports
Arash Moghaddam, André Sperl, Raban Heller, Kevin Kunzmann, Viola Graeser, Michael Akbar, Hans Jürgen Gerner, Bahram Biglari
After traumatic spinal cord injury, an acute phase triggered by trauma is followed by a subacute phase involving inflammatory processes. We previously demonstrated that peripheral serum cytokine expression changes depend on neurological outcome after spinal cord injury. In a subsequent intermediate phase, repair and remodeling takes place under the mediation of growth factors such as Insulin-like Growth Factor 1 (IGF-1). IGF-1 is a promising growth factor which is thought to act as a neuroprotective agent. Since previous findings were taken from animal studies, our aim was to investigate this hypothesis in humans based on peripheral blood serum...
2016: PloS One
Ozgur Demir, Fatih Ersay Deniz, Ismail Benli, Erol Oksuz, Osman Demir, Ilknur Butun
AIM: Because of the need for effective method to determine the severity of head trauma, the importance of biomarkers is recognized recently. This study aims to analyze the values of sera levels of some biomarkers and the relation with their tissue levels in acute head injury. MATERIAL AND METHODS: In this study, rats were divided into three groups (mild head trauma, severe head trauma and control group). All rats were anaesthetized. Weightdrop method was used as trauma method...
2016: Turkish Neurosurgery
Javaher Khajavikhan, Aminolah Vasigh, Taleb Kokhazade, Ali Khani
INTRODUCTION: Head Trauma (HT) is a major cause of death, disability and important public health problem. HT is also the main cause of hyperglycaemia that can increase mortality. AIM: The aim of this study was to assess the correlation between hyperglycaemia with neurological outcomes following severe Traumatic Brain Injury (TBI). MATERIALS AND METHODS: This is a descriptive and correlation study that was carried out at the Imam Khomeini Hospital affiliated with Ilam University of Medical Sciences, Ilam, IR, during March 2014-March 2015 on patients with severe TBI...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Ata Mahmoodpoor, Hadi Hamishehkar, Mohammadtagi Beigmohammadi, Sarvin Sanaie, Kamran Shadvar, Hassan Soleimanpour, Ahsan Rahimi, Saeed Safari
BACKGROUND: Hypoglycemia is a common and the most important complication of intensive insulin therapy in critically ill patients. Because of hypoglycemia's impact on the cardinal organs as a fuel, if untreated it could results in permanent brain damage and increased mortality. OBJECTIVES: In this study, we aim to evaluate the incidence of hypoglycemia, its risk factors, and its relationship with mortality in critically ill patients. PATIENTS AND METHODS: Five hundred adult patients who admitted to an intensive care unit (ICU) were enrolled in this study...
February 2016: Anesthesiology and Pain Medicine
Sagar U Nigwekar, Sophia Zhao, Julia Wenger, Jeffrey L Hymes, Franklin W Maddux, Ravi I Thadhani, Kevin E Chan
Accurate identification of risk factors for calcific uremic arteriolopathy (CUA) is necessary to develop preventive strategies for this morbid disease. We investigated whether baseline factors recorded at hemodialysis initiation would identify patients at risk for future CUA in a matched case-control study using data from a large dialysis organization. Hemodialysis patients with newly diagnosed CUA (n=1030) between January 1, 2010, and December 31, 2014, were matched by age, sex, and race in a 1:2 ratio to hemodialysis patients without CUA (n=2060)...
November 2016: Journal of the American Society of Nephrology: JASN
Mohamed Hisham, Mudalipalayam N Sivakumar, Ganesh Veerasekar
BACKGROUND AND OBJECTIVES: A critically ill patient is treated and reviewed by physicians from different specialties; hence, polypharmacy is a very common. This study was conducted to assess the impact and effectiveness of having a clinical pharmacist in an Indian Intensive Care Unit (ICU). It also evaluates the clinical pharmacist interventions with a focus on optimizing the quality of pharmacotherapy and patient safety. MATERIALS AND METHODS: The prospective, observational study was carried out in medical and surgical/trauma ICU over a period of 1 year...
February 2016: Indian Journal of Critical Care Medicine
Saeyoung Park, Yoonyoung Choi, Namhee Jung, Yeonsil Yu, Kyung-Ha Ryu, Han Su Kim, Inho Jo, Byung-Ok Choi, Sung-Chul Jung
Stem cells are regarded as an important source of cells which may be used to promote the regeneration of skeletal muscle (SKM) which has been damaged due to defects in the organization of muscle tissue caused by congenital diseases, trauma or tumor removal. In particular, mesenchymal stem cells (MSCs), which require less invasive harvesting techniques, represent a valuable source of cells for stem cell therapy. In the present study, we demonstrated that human tonsil-derived MSCs (T-MSCs) may differentiate into myogenic cells in vitro and that the transplantation of myoblasts and myocytes generated from human T-MSCs mediates the recovery of muscle function in vivo...
May 2016: International Journal of Molecular Medicine
Susan J Burke, Michael D Karlstad, J Jason Collier
Carbohydrate, lipid, and protein metabolism are largely controlled by the interplay of various hormones, which includes those secreted by the pancreatic islets of Langerhans. While typically representing only 1% to 2% of the total pancreatic mass, the islets have a remarkable ability to adapt to disparate situations demanding a change in hormone release, such as peripheral insulin resistance. There are many different routes to the onset of insulin resistance, including obesity, lipodystrophy, glucocorticoid excess, and the chronic usage of atypical antipsychotic drugs...
September 2016: Shock
Meagan K Doolin, Todd A Walroth, Serena A Harris, Jessica A Whitten, Andrew C Fritschle-Hilliard
BACKGROUND: Glycemic control decreases morbidity and mortality in critically ill patients. However, limited guidance exists regarding the transition from intravenous (IV) to subcutaneous insulin therapy. A validated protocol for transition is necessary since glycemic variability, hyperglycemia, and hypoglycemia adversely impact patient outcomes. METHOD: The objective was to determine the safest and most effective method to transition critically ill adults from IV to subcutaneous insulin...
July 2016: Journal of Diabetes Science and Technology
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