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Diabetic surgery

Meda E Pavkov, Jessica L Harding, Nilka R Burrows
Acute kidney injury is a sudden decrease in kidney function with or without kidney damage, occurring over a few hours or days. Diabetes, hypertension, and advanced age are primary risk factors for acute kidney injury. It is increasingly recognized as an in-hospital complication of sepsis, heart conditions, and surgery (1,2). Its most severe stage requires treatment with dialysis. Acute kidney injury is also associated with higher likelihood of long-term care, incidence of chronic kidney disease and hospital mortality, and health care costs (1,2)...
March 16, 2018: MMWR. Morbidity and Mortality Weekly Report
B A Kadashev, A N Konovalov, L I Astaf'eva, P L Kalinin, M A Kutin, I S Klochkova, D V Fomichev, O I Sharipov, D N Andreev
The pituitary stalk (PS) is a relatively thin bundle connecting the hypophyseal stalk to the pituitary gland; it consists of both axons of the hypothalamic nuclei (terminating in the neurohypophysis) and the system of portal vessels. Compression of the PS by a space-occupying lesion or its transection (forced or intended) during surgery may lead to the development of endocrine disorders: hypopituitarism, diabetes insipidus, and hyperprolactinemia. The modern literature lacks studies evaluating the severity of endocrine disorders depending on the PS condition before and after surgery...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
M M Bikbov, R R Fayzrakhmanov, M R Kalanov
PURPOSE: To compare morpho-functional parameters of retina during vitrectomy with and without internal limiting membrane (ILM) peeling in patients with proliferative diabetic retinopathy. MATERIAL AND METHODS: The study included 55 patients (55 eyes) that had underwent vitreoretinal surgery in the setting of antivasoproliferative therapy for proliferative diabetic retinopathy. Patients of the 1st group (n=27) underwent vitrectomy with silicone tamponade, 2nd group (n=28) received similar treatment with the addition of ILM peeling...
2018: Vestnik Oftalmologii
Judit Karacsonyi, Ehrin J Armstrong, Huu Tam D Truong, Ryan Tsuda, Damianos G Kokkinidis, Jose Roberto Martinez-Parachini, Aya J Alame, Barbara A Danek, Aris Karatasakis, Michele Roesle, Houman Khalili, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis, Bavana V Rangan
BACKGROUND: The contemporary use and outcomes of excimer laser coronary atherectomy (ELCA) in percutaneous coronary intervention (PCI) are not well described. METHODS: We examined the baseline clinical and angiographic characteristics and procedural outcomes of 130 target lesions in 121 consecutive PCIs (n = 116 patients) in which ELCA was performed at three United States Department of Veterans Affairs (VA) medical centers between 2008 and 2016. RESULTS: Mean age was 68...
March 15, 2018: Journal of Invasive Cardiology
Purva Sharma, Yash Jobanputra, Karen Lewin, Stuart Bagatell, Daniel Lichtstein
BACKGROUND: Diabetic ketoacidosis (DKA) is a serious complication of diabetes seen commonly in autoimmune Type 1 diabetes mellitus (DM), however patients with Type 2 diabetes are also at risk. Diabetic ketoacidosis may be precipitated by the catabolic stress of acute illness such as trauma, surgery, or infections. Recent studies have suggested that sodium glucose cotransporter-2 (SGLT-2) inhibitors precipitate DKA in Type 2 diabetes. We present a case series of four patients on SGLT-2 inhibitors who presented with DKA...
March 13, 2018: Reviews on Recent Clinical Trials
Marc A Furrer, Antoni Vilaseca, Renato B Corradi, Silvan Boxler, George N Thalmann, Daniel P Nguyen
BACKGROUND: A growing number of men undergo repeat biopsies prior to radical prostatectomy for prostate cancer. However, the long-term impact of repeat biopsies on functional outcomes in this patient population remains unelucidated. Thus, we compared functional outcomes between patients who underwent single biopsy versus repeat biopsies before radical prostatectomy. METHODS: From 1996 to 2015, 1015 consecutive patients underwent radical prostatectomy, and subsequently had urinary continence and erectile function assessed for >2 years follow-up...
March 14, 2018: Prostate
Ronaldo Lira-Junior, Sigvard Åkerman, Björn Klinge, Elisabeth A Boström, Anders Gustafsson
BACKGROUND: Analysis of saliva is emerging as a promising tool to diagnose and monitor diseases which makes determination of the salivary microbial profile in different scenarios essential. OBJECTIVE: To evaluate the effects of age, periodontal disease, sex, smoking, and medical conditions on the salivary microbial profile. DESIGN: A randomly selected sample of 441 individuals was enrolled (51% women; mean age 48.5±16.8). Participants answered a health questionnaire and underwent an oral examination...
2018: PloS One
Ramesh Khadka, Wei Jun Tian, Hao Xin, Rakshya Koirala
To review literature addressing determination of the risk factor, early diagnosis and overall survival on outcome among patient of pancreatic cancer associated with diabetes mellitus from the perspective of pancreatic surgery. To identify recent guidelines, clinical pathogenesis, pathological classification, screening methodology and advances in surgical management. It identifies those clinical and surgical variables to predict excellent prognosis in respect of life style changes, ongoing advancement in therapeutic and surgical treatment and postoperative follow up...
March 10, 2018: International Journal of Surgery
Divya Singh, Anita Ganger, Noopur Gupta, Murugesan Vanathi, Rajesh Khadgawat, Radhika Tandon
Here, we present, to the best of our knowledge, the first case of Werner syndrome with corneal blindness due to bilateral primary bullous keratopathy. Werner syndrome is a rare autosomal recessive disorder characterized by features of premature aging, insulin-dependent diabetes mellitus, osteoporosis, atherosclerosis, hypergonadotrophic hypogonadism, hypertriglyceridemia, scleroderma-like skin changes, and sarcomas. Among ocular manifestations, cataracts, cystoid macular edema, and retinal detachment have been reported...
March 9, 2018: Experimental and Clinical Transplantation
Zizhong Hu, Yuzhi Ding, Xinhua Zheng, Songtao Yuan, Jia Li, Ping Xie, Qinghuai Liu
PURPOSE: To design a rigid contact lens (CL) to be used in combination with a wide-angle viewing system and analyze its protection for corneal epithelial during vitreous-retinal surgery. METHODS: A thin and lightweight rigid CL was designed and constructed. The impact of the CL on the visualized fundus range was evaluated using a concrete eye model. Patients with severe proliferative diabetic retinopathy (PDR) were randomized to either the CL group, corneal protective agent (CPA) group, or balanced salt solution (BSS) group...
March 12, 2018: Eye & Contact Lens
Taraprasad Das
PURPOSE: The International Agency for Prevention of Blindness (IAPB) South East Asia region (SEAR) that consists of 11 countries contains 26% of the world's population (1,761,000,000). In this region 12 million are blind and 78.5 million are visually impaired. This amounts to 30% of global blindness and 32% of global visual impairment. DESIGN: Rapid assessment of avoidable blindness (RAAB) survey analysis. METHODS: RAAB, either a repeat or a first time survey, was completed in 8 countries in this decade (2010 onwards)...
March 13, 2018: Asia-Pacific Journal of Ophthalmology
Laurentiu M Pop, Andrea Mari, Tong-Jin Zhao, Lori Mitchell, Shawn Burgess, Xilong Li, Beverley Adams-Huet, Ildiko Lingvay
AIM: To investigate the physiological mechanisms leading to rapid improvement in diabetes after Roux-en-Y Gastric Bypass (RYGB). In particular, the roles of concurrent peri-operative dietary restrictions, which may also alter glucose metabolism, have not been completely elucidated. MATERIALS AND METHODS: To assess the differential contributions of diet and surgery to the mechanisms leading to the rapid improvement in diabetes after RYGB we enrolled ten patients with type 2 diabetes scheduled to undergo RYGB...
March 13, 2018: Diabetes, Obesity & Metabolism
Zaina AlBalawi, Leah Gramlich, Gregg Nelson, Peter Senior, Erik Youngson, Finlay A McAlister
BACKGROUND: The Enhanced Recovery After Surgery (ERAS) program has been shown to reduce length of stay (LOS) in colorectal surgical patients in randomized trials. The impact outside of trial settings, or in subgroups of patients excluded from trials such as individuals with diabetes, is uncertain. We conducted this study to evaluate the impact of ERAS implementation in Alberta, Canada. METHODS: This is a retrospective cohort study and interrupted time series analysis using linked administrative data to examine LOS and postoperative outcomes in the 12 months pre- and post-implementation of ERAS in 2013 for all adults undergoing elective colorectal surgery...
March 12, 2018: World Journal of Surgery
Thomas H Inge, Lori M Laffel, Todd M Jenkins, Marsha D Marcus, Natasha I Leibel, Mary L Brandt, Morey Haymond, Elaine M Urbina, Lawrence M Dolan, Philip S Zeitler
Importance: Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that will achieve better glycemic control than standard medical management. Objective: To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions. Design, Setting, and Participants: A secondary analysis of data collected by the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) and Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) consortia was performed...
March 12, 2018: JAMA Pediatrics
Faris Shweikeh, Stephanie Zyck, Fadi Sweiss, Ajleeta Sangtani, Mohammed Shweikeh, Husam Issa, Michael P Steinmetz, Georges Z Markarian
Study design: In this review, we present a case of Aspergillus spinal epidural abscess (ASEA) and review the literature. Objectives: To provide further insight on a rare condition. Setting: A description of a patient with ASEA in a 58-year-old woman that was successfully treated with conservative management is presented. Methods: Following case presentation, a literature search (MedLine and PubMed) and assessment of epidemiology, presentation, diagnosis, treatments, and outcomes is performed...
2018: Spinal Cord Series and Cases
David R Dobies, Kimberly R Barber
Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials...
2018: Open Heart
S Gooran, A Javid, G Pourmand
One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor...
2018: International Journal of Organ Transplantation Medicine
Wenli Chang, Hongzhi Lv, Chen Feng, Peizhi Yuwen, Ning Wei, Wei Chen, Yingze Zhang
OBJECTIVE: Although many studies have reported risk factors of mortality following hip fracture surgery, the preventable risk factors of mortality following hip fracture surgery have not been well-identified. The aim of this study was to identify the preventable risk factors of mortality following hip fracture surgery. METHODS: We searched PubMed, Web of Science, Google scholar, and the Chinese National Knowledge Infrastructure (CNKI) databases from January 1997 to March 2017 for studies reporting risk factors of mortality following hip fracture surgery...
March 9, 2018: International Journal of Surgery
Robyn L Houlden, Joy L Yen, Sarah Moore
OBJECTIVES: Bariatric surgery is an effective treatment for patients with type 2 diabetes and refractory obesity; however, many patients have nonoptimal glycemic control preoperatively. We created an interprofessional bariatric glycemic optimization clinic. Patients were seen monthly and received weekly phone calls. We analyzed the effectiveness in assisting patients reach a preoperative glycated hemoglobin (A1C) level of <7.5%. METHODS: Data were analyzed for the first 75 patients...
December 26, 2017: Canadian Journal of Diabetes
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