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Perioperative glycemic control

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https://www.readbyqxmd.com/read/28898714/effect-of-follow-up-by-a-hospital-diabetes-care-team-on-diabetes-control-at-one-year-after-discharge-from-the-hospital
#1
Rajesh Garg, Shelley Hurwitz, Raquel Rein, Brooke Schuman, Patricia Underwood, Shreya Bhandari
AIM: This study was conducted to evaluate the effect of continued follow-up by a hospital diabetes team on HbA1c at 1-year after discharge. METHODS: Adults with HbA1c ≥8% (64mmol/mol), undergoing an elective surgery, were treated in the perioperative period and randomized to continued care (CC) or the usual care (UC) after discharge. Patients in the CC group received weekly to monthly phone calls from a diabetes specialist nurse practitioner (NP) to review their home blood glucose values, diet, exercise, and medications...
August 24, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28844470/high-hemoglobin-a1c-associated-with-increased-adverse-limb-events-in-peripheral-arterial-disease-patients-undergoing-revascularization
#2
Shipra Arya, Zachary O Binney, Anjali Khakharia, Chandler A Long, Luke P Brewster, Peter W Wilson, William D Jordan, Yazan Duwayri
OBJECTIVE: Diabetes and peripheral arterial disease (PAD) are independently associated with increased risk of amputation. However, the effect of poor glycemic control on adverse limb events has not been studied. We examined the effects of poor glycemic control (high hemoglobin A1c level) on the risk of amputation and modified major adverse limb events (mMALEs) after lower extremity revascularization. METHODS: Patients undergoing PAD revascularization who had hemoglobin A1c (HbA1c) levels available within 6 months were identified in the Veterans Affairs database of 2003 to 2014 (N = 26,799)...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28833518/post-sternotomy-mediastinitis-in-the-modern-era
#3
Siew S C Goh
BACKGROUND: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. METHODS: This review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery...
August 22, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28820780/clinical-effectiveness-of-intravenous-exenatide-infusion-in-perioperative-glycemic-control-after-coronary-artery-bypass-graft-surgery-a-phase-ii-iii-randomized-trial
#4
Guillaume Besch, Andrea Perrotti, Frederic Mauny, Marc Puyraveau, Maude Baltres, Guillaume Flicoteaux, Lucie Salomon du Mont, Benoit Barrucand, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
BACKGROUND: We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients. METHODS: Patients more than 18 yr old admitted for elective coronary artery bypass grafting were included in a phase II/III nonblinded randomized superiority trial. Current insulin use and creatinine clearance of less than 60 ml/min were exclusion criteria. Two groups were compared: the exenatide group, receiving exenatide (1-h bolus of 0...
August 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#5
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28716378/reducing-infection-rates-through-perioperative-glycemic-control-how-sweet-it-is
#6
EDITORIAL
Sean C Dowdy, Timothy B Curry, Robert R Cima
No abstract text is available yet for this article.
August 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28708482/metabolic-surgery-for-treating-type-2-diabetes-mellitus-now-supported-by-the-world-s-leading-diabetes-organizations
#7
REVIEW
Philip R Schauer, Zubaidah Nor Hanipah, Francesco Rubino
The term metabolic surgery describes bariatric surgical procedures used primarily to treat type 2 diabetes and related metabolic conditions. Originally, bariatric surgery was used as an alternative weight-loss therapy for patients with severe obesity, but clinical data revealed its metabolic benefits in patients with type 2 diabetes. Metabolic surgery is more effective than lifestyle or medical management in achieving glycemic control, sustained weight loss, and reducing diabetes comorbidities. Perioperative adverse events are similar to other gastrointestinal surgeries...
July 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28695457/the-role-of-laboratory-testing-in-differentiating-type-1-diabetes-from-type-2-diabetes-in-patients-undergoing-bariatric-surgery
#8
Scott J Pilla, Nisa M Maruthur, Michael A Schweitzer, Thomas H Magnuson, James J Potter, Jeanne M Clark, Clare J Lee
BACKGROUND: It may be difficult to distinguish between adults with type 1 diabetes and type 2 diabetes by clinical assessment. In patients undergoing bariatric surgery, it is critical to correctly classify diabetes subtype to prevent adverse perioperative outcomes including diabetic ketoacidosis. This study aimed to determine whether testing for C-peptide and islet cell antibodies during preoperative evaluation for bariatric surgery could improve the classification of type 1 versus type 2 diabetes compared to clinical assessment alone...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#9
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this disease interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#10
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
August 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28502888/prospective-study-of-postoperative-glycemic-control-with-a-standardized-insulin-infusion-protocol-after-infrainguinal-bypass-and-open-abdominal-aortic-aneurysm-repair
#11
Andrea M Steely, Lisa Smith, Peter W Callas, Muriel H Nathan, Julie E Lahiri, Andrew C Stanley, Georg Steinthorsson, Daniel J Bertges
BACKGROUND: The aim of this study is to examine the effect of moderate postoperative glycemic control in diabetic and nondiabetic patients undergoing infrainguinal bypass (INFRA) or open abdominal aortic aneurysm (OAAA) repair. METHODS: In a single center prospective study, we investigated postoperative glycemic control using a standardized insulin infusion protocol after elective INFRA bypass (n = 53, 62%) and OAAA repair (n = 33, 38%) between January 2013 and March 2015...
May 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28492399/acute-kidney-injury-after-pediatric-cardiac-surgery-a-secondary-analysis-of-the-safe-pediatric-euglycemia-after-cardiac-surgery-trial
#12
Joshua J Blinder, Lisa A Asaro, David Wypij, David T Selewski, Michael S D Agus, Michael Gaies, Michael A Ferguson
OBJECTIVES: To understand the effect of tight glycemic control on cardiac surgery-associated acute kidney injury. DESIGN: Secondary analysis of data from the Safe Pediatric Euglycemia after Cardiac Surgery trial of tight glycemic control versus standard care. SETTING: Pediatric cardiac ICUs at University of Michigan, C.S. Mott Children's Hospital, and Boston Children's Hospital. PATIENTS: Children 0-36 months old undergoing congenital cardiac surgery...
July 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28343046/perioperative-hemoglobin-a1c-as-a-predictor-of-deep-infection-following-single-level-lumbar-decompression-in-patients-with-diabetes
#13
Jourdan M Cancienne, Brian C Werner, Dennis Q Chen, Hamid Hassanzadeh, Adam L Shimer
BACKGROUND CONTEXT: Although multiple studies have cited diabetes mellitus as a risk factor decreased functional outcomes, increased infectious complications, and overall increased reoperation rate following degenerative lumbar spinal surgery, few have investigated how perioperative glycemic control influences such complications. PURPOSE: The primary goal of the present study was to use a national database to evaluate the association of perioperative glycemic control as demonstrated by Hemoglobin A1c levels in patients with diabetes undergoing primary, single level decompression without concomitant fusion with the incidence of deep postoperative infection following requiring operative irrigation and debridement...
March 22, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28279772/the-association-of-perioperative-glycemic-control-with-deep-postoperative-infection-after-anterior-cervical-discectomy-and-fusion-in-patients-with-diabetes
#14
Jourdan M Cancienne, Brian C Werner, Hamid Hassanzadeh, Anuj Singla, Frank H Shen, Adam L Shimer
OBJECTIVE: To evaluate the association of perioperative hemoglobin A1c (HbA1c) level in patients with diabetes with the incidence of infection after anterior cervical discectomy and fusion requiring operative intervention, in addition to determining if a threshold level of HbA1c above which the risk of infection increases significantly exists. METHODS: A national administrative database was queried for patients who underwent primary anterior cervical discectomy and fusion with diabetes who had a perioperative HbA1c level recorded within 3 months of surgery...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28256333/-the-effect-of-two-different-glycemic-management-protocols-on-postoperative-cognitive-dysfunction-in-coronary-artery-bypass-surgery
#15
Pinar Kurnaz, Zerrin Sungur, Emre Camci, Nukhet Sivrikoz, Gunseli Orhun, Mert Senturk, Omer Sayin, Emin Tireli, Hakan Gurvit
INTRODUCTION: Postoperative cognitive dysfunction (POCD) is an adverse outcome of surgery that is more common after open heart procedures. The aim of this study is to investigate the role of tightly controlled blood glucose levels during coronary artery surgery on early and late cognitive decline. METHODS: 40 patients older than 50 years undergoing elective coronary surgery were randomized into two groups. In the "Tight Control" group (GI), the glycemia was maintained between 80 and 120mg·dL(-1) while in the "Liberal" group (GII), it ranged between 80-180mg·dL(-1)...
May 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28253605/-glycemic-control-of-chinese-adult-patients-in-perioperative-period
#16
Y Wu, H M Tian
No abstract text is available yet for this article.
March 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28197046/outcome-of-noncardiac-surgical-patients-admitted-to-a-multidisciplinary-intensive-care-unit
#17
Pradeep Kumar, M K Renuka, M S Kalaiselvan, A S Arunkumar
CONTEXT: Surgical procedures carry significant morbidity and mortality depending on the type of surgery and patients. There is a dearth of evidence from India on the outcome of surgical patients admitted to an Intensive Care Unit (ICU). AIMS: We aimed to describe the incidence and risk factors of postoperative complications and mortality in noncardiac surgical patients admitted to the ICU. SETTINGS AND DESIGN: This was a prospective observational study on all perioperative patients admitted to a multidisciplinary ICU for 18 months...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28183563/effect-of-basal-insulin-dosage-on-blood-glucose-concentration-in-ambulatory-surgery-patients-with-type-2-diabetes
#18
Linda J Demma, Karen T Carlson, Elizabeth W Duggan, John Gordon Morrow, Guillermo Umpierrez
STUDY OBJECTIVE: Among patients with type 2 diabetes treated with insulin, perioperative hyperglycemia and hypoglycemia may cause undesirable symptoms, surgery delay or cancellation, or unexpected hospitalization. Our objective was to compare preoperative glargine dosing regimens on perioperative glycemic control in patients undergoing ambulatory surgery. DESIGN: Observational study. SETTING: Pre- and postoperative holding areas. PATIENTS: One hundred fifty patients with type 2 diabetes using a once daily, evening insulin glargine regimen undergoing ambulatory surgery were included...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28161384/hospitalization-costs-and-clinical-outcomes-in-cabg-patients-treated-with-intensive-insulin-therapy
#19
Saumeth Cardona, Francisco J Pasquel, Maya Fayfman, Limin Peng, Sol Jacobs, Priyathama Vellanki, Jeff Weaver, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo E Umpierrez
BACKGROUND: The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known. METHODS: This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control...
April 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28096825/determination-of-the-value-of-glycated-hemoglobin-hba1c-and-fructosamine-in-assessing-the-risk-of-perioperative-complications-after-cardiac-surgery-in-patients-with-type-2-diabetes
#20
Anetta M Kowalczuk-Wieteska, Marta Wróbel, Dominika Rokicka, Aleksandra Szymborska-Kajanek, Jerzy Foremny, Paweł Nadziakiewicz, Marian Zembala, Krzysztof Strojek
INTRODUCTION: Patients with diabetes have a worse postoperative course and longer length of hospital stay after surgery. A good indicator of proper long-term (3 months) glycemic control is glycated hemoglobin (HbA1c), and fructosamine in the short term (2-3 weeks). AIM: To determine the degree of glycemic control evaluated preoperatively by HbA1c and/or fructosamine influence on the postoperative course of patients with diabetes undergoing coronary artery bypass grafting (CABG) in 2014-2015...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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