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Diabete in anesthesia

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https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#1
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27903337/-risk-factors-for-perioperative-stroke-in-aged-patients-undergoing-nonneurologic-and-noncardiovascular-surgery
#2
B L Jiang, L Yao, Y Feng, J H Liu
Objective: To assess the incidence, risk factors, and outcomes of perioperative stroke in aged patients undergoing nonneurologic and noncardiovascular surgery. Methods: A total of 21 419 in-patients who were older than 65 years undergoing nonneurologic and noncardiovascular surgery in Peking University People's Hospital from January 2010 to May 2016 were retrospectively recruited in this study.The patients were divided into two groups: patients with perioperative stroke were allocated in stroke group, and the other patients were in the non-stroke group...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27875102/obesity-increases-operative-time-in-children-undergoing-laparoscopic-cholecystectomy
#3
T K Pandian, Daniel S Ubl, Elizabeth B Habermann, Christopher R Moir, Michael B Ishitani
INTRODUCTION: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. MATERIALS AND METHODS: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27833245/buccal-mucosal-graft-urethroplasty-for-proximal-bulbar-urethral-stricture-a-revisit-of-the-surgical-technique-and-analysis-of-eleven-consecutive-cases
#4
Irekpita Eshiobo, Esezobor Ehizomen, F Omosofe, V Onuora
BACKGROUND: Urethral stricture disease is prevalent, and many surgical techniques have been developed to treat it. Currently, urethroplasty for bulbar strictures implies ventral or dorsal stricturotomy and a buccal mucosa graft (BMG) patch. OBJECTIVE: To describe the surgical approach of the ventral patch BMG urethroplasty for proximal bulbar urethral stricture and to analyze 11 consecutive cases for whom the technique was used. PATIENTS AND METHODS: The diagnosis of urethral stricture was confirmed with a combined retrograde urethrography and micturating cystourethrography...
September 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
https://www.readbyqxmd.com/read/27802272/isoflurane-and-sevoflurane-induce-severe-hepatic-insulin-resistance-in-a-canine-model
#5
Stella P Kim, Josiane L Broussard, Cathryn M Kolka
INTRODUCTION: Anesthesia induces insulin resistance, which may contribute to elevated blood glucose and adverse post-operative outcomes in critically ill patients, and impair glycemic control in surgical patients with diabetes. However, little is known about the mechanisms by which anesthesia impairs insulin sensitivity. Here we investigate the effects of anesthesia on insulin sensitivity in metabolic tissues. METHODS: Hyperinsulinemic-euglycemic clamps were performed in 32 lean (control diet; n = 16 conscious versus n = 16 anesthetized) and 24 fat-fed (6 weeks fat-feeding; n = 16 conscious versus n = 8 anesthetized) adult male mongrel dogs in conjunction with tracer methodology to differentiate hepatic versus peripheral insulin sensitivity...
2016: PloS One
https://www.readbyqxmd.com/read/27793402/one-year-outcomes-of-transcatheter-aortic%C3%A2-valve-implantation-using-the-direct%C3%A2-aortic%C3%A2-approach
#6
Giuseppe Bruschi, Marian Branny, Molly Schiltgen, Federica Ettori, Bertrand Marcheix, Hafid Amrane, Hasan Bushnaq, M Erwin S H Tan, Uday Trivedi, Piotr Branny, Silvio Klugmann, Giuseppe Coletti, Nicolas Dumonteil, Fabiano Porta, Anna Nordell, Neil Moat
BACKGROUND: The direct aortic (DA) approach allows for transcatheter aortic valve implantation (TAVI) in patients with difficult peripheral vascular anatomy. The CoreValve ADVANCE Direct Aortic (ADVANCE DA) study was performed to assess the outcomes of DA TAVI with the CoreValve System (Medtronic, Minneapolis, MN) in routine practice. METHODS: Patients were selected for the DA approach by local cardiac surgical teams, and TAVI was performed with patients under general anesthesia...
October 25, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27780820/activation-of-%C3%AE-3-adrenoceptors-increases-in-vivo-free-fatty-acid-uptake-and-utilization-in-brown-but-not-white-fat-depots-in-high-fat-fed-rats
#7
Amy Warner, Ann Kjellstedt, Alba Carreras, Gerhard Böttcher, Xiao-Rong Peng, Patrick Seale, Nicholas Oakes, Daniel Lindén
Activation of brown adipose tissue (BAT) and browning of white adipose tissue (WAT) present potential new therapies for obesity and type 2 diabetes. Here, we examined the effects of β3-adrenergic stimulation on tissue-specific uptake and storage of free fatty acids (FFA) and its implications for whole body FFA metabolism in diet-induced obese rats using a multi-radiotracer technique. Male Wistar rats were high fat-fed for 12 wk and administered β3-agonist CL316,243 (CL, 1 mg·kg(-1)·day(-1)) or saline via osmotic minipumps during the last 3 wk...
December 1, 2016: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27778491/feasibility-of-robot-assisted-segmental-ureterectomy-and-ureteroureterostomy-in-patient-with-high-medical-comorbidity
#8
Ali Abdel Raheem, Atalla Alatawi, Dae Keun Kim, Abulhasan Sheikh, Koon Ho Rha
INTRODUCTION AND OBJECTIVES: Nephroureterectomy remains the gold standard treatment option for upper tract tumors. However, segmental ureterectomy may be another option in patients with single kidney, borderline renal function or high medical comorbidities. The aim of this video is to assess the feasibility of robotic surgery as a minimally invasive technique in treatment of a high comorbid patient with ureteric tumor. MATERIALS AND METHODS: Eighty-year old male patient, with a medical history of chronic hypertensive and uncontrolled Diabetes Mellitus, was referred to our department for treatment of ureteric tumor...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27767680/postoperative-urinary-retention-in-patients-undergoing-elective-spinal-surgery
#9
David Altschul, Andrew Kobets, Jonathan Nakhla, Ajit Jada, Rani Nasser, Merritt D Kinon, Reza Yassari, John Houten
OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period...
October 21, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27765179/from-the-laboratory-bench-to-the-operating-room-the-role-of-the-surgeon-in-cancer-prevention
#10
Terry C Lairmore
BACKGROUND: The last 200 years have seen remarkable achievements in the art and clinical practice of surgery. These advances include the introduction of antisepsis, anesthesia, vascular anastomosis, antimicrobials, organ transplantation, and the widespread application of minimally invasive operative procedures. Very recently, a surgical procedure has been shown to cure diabetes, representing the most effective treatment of a metabolic disorder by surgeons. METHODS: The author reviewed the major surgical milestones in the modern surgical era and prepared this monograph for presentation as the Claude H...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27752032/starvation-ketoacidosis-as-a-cause-of-unexplained-metabolic-acidosis-in-the-perioperative-period
#11
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27741203/maternal-and-neonatal-outcomes-with-early-compared-with-delayed-pushing-among-nulliparous-women
#12
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27737296/incidence-of-and-risk-factors-for-symptomatic-venous-thromboembolism-after-shoulder-arthroplasty
#13
Robert Z Tashjian, Daniel T Lilly, Aaron M Isaacson, Cory E Georgopoulos, Stephen P Bettwieser, Robert T Burks, Patrick E Greis, Angela P Presson, Erin K Granger, Yue Zhang
Reported rates of venous thromboembolism (VTE) after shoulder arthroplasty (SA) range from 0.2% to 13%. Few studies have evaluated the incidence of VTE in a large patient population from a single institution. We conducted a study to determine the incidence of VTE (deep venous thrombosis [DVT] and pulmonary embolism [PE]) in a large series of SAs. Cases of SAs performed at our institution between January 1999 and May 2012 were retrospectively reviewed for development of symptomatic VTE within the first 90 days after surgery...
September 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27699461/the-use-of-integra-dermal-regeneration-template-versus-flaps-for-reconstruction-of-full-thickness-scalp-defects-involving-the-calvaria-a-cost-benefit-analysis
#14
M Schiavon, M Francescon, D Drigo, G Salloum, R Baraziol, J Tesei, E Fraccalanza, F Barbone
BACKGROUND: INTEGRA(®) Dermal Regeneration Template is a well-known and widely used acellular dermal matrix. Although it helps to solve many challenging problems in reconstructive surgery, the product cost may make it an expensive alternative compared to other reconstruction procedures. This retrospective study aims at comparing INTEGRA-based treatment to flap surgery in terms of cost and benefit. PATIENTS AND METHODS: We considered only patients treated for scalp defects with bone exposure in order to obtain two groups as homogeneous as possible...
December 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27686470/risk-factors-for-return-to-the-operating-room-after-resident-performed-cataract-surgery
#15
Shivali A Menda, Todd H Driver, Alexandra E Neiman, Seth Blumberg, Ayman Naseri, Jay M Stewart
OBJECTIVE: Investigate risk factors for unplanned return to the operating room after resident-performed cataract surgery. DESIGN: Retrospective case-control study. SETTING: Institutional. METHODS: Study population: All patients with reoperation within 90 days of resident-performed phacoemulsification were matched to four control eyes which had surgery within 30 days of the reoperation at the same institution. OBSERVATION PROCEDURE: Billing codes were used to identify all patients who underwent resident-performed intended phacoemulsification with intraocular lens placement from January 2005 to December 2010...
September 29, 2016: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/27651131/the-effect-of-perioperative-insulin-treatment-on-cardiodepression-in-mild-adiposity-in-mice
#16
Chantal A Boly, Etto C Eringa, R Arthur Bouwman, Rob F P van den Akker, Frances S de Man, Ingrid Schalij, Stephan A Loer, Christa Boer, Charissa E van den Brom
BACKGROUND: While most studies focus on cardiovascular morbidity following anesthesia and surgery in excessive obesity, it is unknown whether these intraoperative cardiovascular alterations also occur in milder forms of adiposity without type 2 diabetes and if insulin is a possible treatment to improve intraoperative myocardial performance. In this experimental study we investigated whether mild adiposity without metabolic alterations is already associated with cardiometabolic dysfunction during anesthesia, mechanical ventilation and surgery and whether these myocardial alterations can be neutralized by intraoperative insulin treatment...
2016: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/27649397/the-advantages-of-dermoscopy-in-the-diagnosis-of-acral-melanoma-from-other-podiatric-lesions-a-literature-review
#17
Mansi Patel, HyunJi Boo, Suganthi Kandasamy, Dhagash Patel, Anthony Iorio
INTRODUCTION AND OBJECTIVES: Melanoma is one of the most common primary malignant tumors arising in the lower extremity. It is crucial to diagnose melanoma as quickly and as efficiently as possible for a better prognosis. The use of dermoscopy is helpful in diagnosing such conditions. Dermoscopy is a non-invasive, in-vivo technique primarily used in the examination of pigmented skin lesions. This procedure allows the visualization of subsurface skin structures in the epidermis, dermoepidermal junction, and upper dermis - structures not visible to the naked eye...
September 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27648000/impact-of-diabetes-mellitus-on-radial-and-ulnar-arterial-vasoreactivity-after-radial-artery-cannulation-a-randomized-controlled-trial
#18
Eun Jung Kim, Sarah Soh, So Yeon Kim, Hae Keum Kil, Jae Hoon Lee, Jeong Min Kim, Tae Whan Kim, Bon-Nyeo Koo
BACKGROUND: Endothelial dysfunction associated with diabetes mellitus (DM) may influence arterial vasoreactivity after arterial stimulus, such as cannulation, and cause changes in diameter and blood flow. Despite the frequent use of arterial cannulation during anesthesia and critical care, little information is available regarding vasoreactivity of the radial and ulnar arteries and its influence on underlying DM. METHODS: Forty non-DM and 40 DM patients, who required arterial cannulation during general anesthesia, were enrolled...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27647792/risk-factors-for-cognitive-impairment-in-fragile-x-associated-tremor-ataxia-syndrome
#19
Andreea L Seritan, Kyoungmi Kim, Ian Benjamin, Ioana Seritan, Randi J Hagerman
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late-onset neurodegenerative disease with motor, psychiatric, and cognitive manifestations that occurs in carriers of the fragile X mental retardation 1 (FMR1) gene premutations. This was a retrospective chart review of 196 individuals (127 men and 69 women) with FXTAS. Forty-six (23%) participants were cognitively impaired, of whom 19 (10%) had dementia. Risk factors for dementia were examined (CGG repeat size; alcohol, benzodiazepine, and opioid use; diabetes; hyperlipidemia; hypertension; hypothyroidism; obesity; sleep apnea; surgeries with general anesthesia; depression; family history of dementia)...
September 19, 2016: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/27642774/hot-topics-in-the-multicenter-orthopedics-outcomes-network-anterior-cruciate-ligament
#20
Robert W Westermann, Thomas Sean Lynch, Kurt P Spindler
Since 2015, the Multicenter Orthopedic Outcomes Network (MOON) has addressed several factors associated with patient outcome after anterior cruciate ligament (ACL) injury. These factors include predictors of high grade knee laxity, the impact of meniscus treatment on joint space narrowing after surgery, graft selection, treating diabetic patients, predictors of clinically significant pain, and outcomes of patients where meniscus tears were left in situ without treatment. The presence of meniscus tears and generalized laxity predict a lax examination under anesthesia prior to surgery...
October 2016: Journal of Knee Surgery
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