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https://www.readbyqxmd.com/read/29353319/management-strategies-for-noncardiac-surgery-following-a-coronary-artery-event
#1
REVIEW
Thomas F Whayne, Sibu P Saha
PURPOSE OF REVIEW: Coronary artery event includes acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Following such an event, risk of noncardiac surgery is increased. Of major concern is what can make this surgery safer? RECENT FINDINGS: High functional capacity improves cardiovascular (CV) risk; at least 4.0 metabolic equivalents (METs) on stress test are favorable. Risk scores can suggest need for further evaluation...
January 20, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29353045/functionally-compromised-synovium-derived-mesenchymal-stem-cells-in-charcot-neuroarthropathy
#2
Reed Mitchell, Jeremy Molligan, Sydney Rooney, Young Cho, Lew Schon, Zijun Zhang
Charcot neuroarthropathy (CNA) often presents as a diabetic foot complication. The role of synovial mesenchymal stem cells (syn-MSCs) in the pathogenesis of CNA is unclear. Synovial samples were collected, for isolation of syn-MSCs, from diabetic patients with CNA (n=7) and non-diabetic patients with intra-articular fracture or normal joints (non-CNA; n=7) during foot surgery. The syn-MSCs in the CNA and non-CNA groups were characterized comparatively. The average number of colonies formed in the CNA group was 6±3...
January 15, 2018: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/29352513/morbid-obesity-and-type-2-diabetes-alter-intestinal-fatty-acid-uptake-and-blood-flow
#3
Jukka Koffert, Mia Ståhle, Henry Karlsson, Patricia Iozzo, Paulina Salminen, Anne Roivainen, Pirjo Nuutila
BACKGROUND AND AIMS: Bariatric surgery is the most effective treatment to tackle morbid obesity and type 2 diabetes, but the mechanisms of action are still unclear. The objective of this study was to investigate the effects of bariatric surgery on intestinal fatty acid (FA) uptake and blood flow. MATERIALS AND METHODS: We recruited 27 morbidly obese subjects of which 10 had type 2 diabetes and 15 healthy age-matched controls. Intestinal blood flow and fatty acid uptake from circulation were measured during fasting state using positron emission tomography (PET)...
January 20, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29351428/control-of-appetite-blood-glucose-and-blood-pressure-during-melanocortin-4-receptor-activation-in-normoglycemic-and-diabetic-npy-deficient-mice
#4
Alexandre A da Silva, John Nathan Freeman, John E Hall, Jussara M do Carmo
Although central melanocortin 4 receptor (MC4R) blockade abolishes the CNS-mediated anorexogenic, antidiabetic and cardiovascular actions of leptin, chronic MC4R stimulation fails to completely mimic leptin's effects. Because neuropeptide Y (NPY) and MC4R exert opposite effects on cardiovascular and metabolic functions, we tested its role in offsetting the long-term actions of MC4R activation. Wild-type (WT) and NPY-deficient (NPY-/-) mice were implanted with telemetry probes for measuring mean arterial pressure (MAP) and heart rate (HR) 24-h/d...
December 20, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29351394/bile-acid-profiles-within-the-enterohepatic-circulation-in-a-diabetic-rat-model-after-bariatric-surgeries
#5
Meng Wei, Yi Shao, Qiao-Ran Liu, Qun-Zheng Wu, Xiang Zhang, Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, San-Yuan Hu
Bile acids (BAs), which are synthesized in the liver and cycled in the enterohepatic circulation, have been recognized as signaling molecules by activating their receptors in the intestine and liver. Serum taurine-conjugated BAs have been shown to be elevated after bariatric surgeries, although the postoperative BA profiles within the enterohepatic circulation have not been investigated. Clarification of these profiles could help explain the mechanisms by which bariatric surgery leads to BA profile alterations and subsequent metabolic effects...
December 21, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29349984/-risk-factors-analysis-on-wound-complications-after-closed-calcaneal-frature-operation-using-lateral-extensive-l-shaped-incision
#6
Xin-Xing Fan, Yang Shen, Wen-Long Xie
OBJECTIVE: To investigate the risk factors of wound complications after closed calcaneal fracture operation using a lateral extensive L-shaped incision and to explore the effective interventions to reduce the complications after incision. METHODS: Retrospective analysis of clinical data of 285 patients(315 calcaneal fractures) who underwent open reduction and internal fixation by using the lateral extensive L-shaped incision from January 2011 to January 2015. Eighteen factors which might cause the complications of calcaneal incision were compared by univariate analysis, and multiple Logistic regression analysis was performed for factors with statistically significances...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29349843/pregnancy-after-bariatric-surgery-maternal-and-fetal-outcomes-of-39-pregnancies-and-a-literature-review
#7
Maria Manuel Costa, Sandra Belo, Pedro Souteiro, João S Neves, Daniela Magalhães, Rita B Silva, Sofia C Oliveira, Paula Freitas, Ana Varela, Joana Queirós, Davide Carvalho
AIM: We aimed to evaluate the impact of bariatric surgery (BS) on maternal and fetal outcomes. METHODS: A retrospective, descriptive, observational study of 39 pregnant women who underwent BS in our institution between 2010 and 2014 was carried out. A sample of women who became pregnant after BS was evaluated, based on data concerning pregnancy, childbirth, and newborns. RESULTS: Of the 1182 patients who underwent BS at our institution during the study period, 1016 (85...
January 18, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29348987/rhino-orbital-cerebral-mucormycosis-a-fatal-complication-of-uncontrolled-diabetes-mellitus
#8
Purva Bavikar, Varshil Mehta
Mucormycosis is a progressively invasive disease, with a fatal outcome, on late presentation. A 38-year-old female presented with diabetic ketoacidosis with right eye ptosis and a frozen globe without any signs of inflammation, externally. She underwent transnasal endoscopic debridement of paranasal sinuses and exenteration of the right eye. The histopathology specimen revealed the growth of mucormycosis. She was treated with intravenous (IV) amphotericin B, IV insulin, and extensive debridement surgery, but had an unfavorable outcome due to rapid mucor invasion to the brain...
November 13, 2017: Curēus
https://www.readbyqxmd.com/read/29344438/new-therapeutic-approaches-in-obesity-and-metabolic-syndrome-associated-with-polycystic-ovary-syndrome
#9
REVIEW
Fatima Saleem, Syed W Rizvi
Polycystic ovary syndrome (PCOS) is a pathophysiological disorder affecting reproductive and metabolic indices. PCOS is commonly associated with a high prevalence of insulin resistance and obesity; this association carries an increased risk of developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. Guidelines recommend lifestyle modification, metformin, hormonal contraceptives (HCs), and bariatric surgery as the main treatment options in obese patients with PCOS. Studies are being conducted to test the efficacy of existing treatment options as well as to discover new therapies...
November 13, 2017: Curēus
https://www.readbyqxmd.com/read/29343528/effect-of-intravitreal-triamcinolone-acetonide-injection-at-the-end-of-vitrectomy-for-vitreous-haemorrhage-related-to-proliferative-diabetic-retinopathy
#10
Yoshihiro Takamura, Masahiko Shimura, Takashi Katome, Hideaki Someya, Masahiko Sugimoto, Takao Hirano, Taiji Sakamoto, Makoto Gozawa, Takehiro Matsumura, Masaru Inatani
BACKGROUND/AIMS: To investigate whether intravitreal injection of triamcinolone acetonide (IVTA) combined with vitrectomy prevents postoperative inflammation in patients with vitreous haemorrhage (VH) due to proliferative diabetic retinopathy (PDR). METHODS: This prospective, multicentre, randomised study conducted at seven sites in Japan enrolled patients diagnosed as having VH following PDR. Patients underwent vitrectomy with (IVTA+VIT group) or without (VIT group) IVTA at the end of the surgery...
January 17, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29343294/effect-of-glycaemic-control-on-complications-following-cardiac-surgery-literature-review
#11
REVIEW
M Navaratnarajah, R Rea, R Evans, F Gibson, C Antoniades, A Keiralla, M Demosthenous, G Kassimis, G Krasopoulos
INTRODUCTION: No uniform consensus in the UK or Europe exists, for glycaemic management of patients with Diabetes or pre-diabetes undergoing cardiac surgery. OBJECTIVE: [i] Determine the relationship between glycaemic control and cardiac surgical outcomes; [ii] Compare current vs gold standard management of patients with Diabetes or pre-diabetes undergoing cardiac surgery. METHODS: Searches of MEDLINE, NHS Evidence and Web of Science databases were completed...
January 17, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29343033/-clinical-features-and-prognosis-of-18-cases-of-primary-lymphocytic-hypophysitis
#12
Q Wei, G Q Yang, Y J Li, L Zang, Y Pei, J Du, W J Gu, J M Ba, Z H Lü, J T Dou, Y M Mu, J M Lu
Objective: To analyze clinical features, prognosis and treatment of lymphocytic hypophysitis (LYH). Methods: The clinical data, treatments and outcomes of 18 cases diagnosed as LYH at Chinese PLA General Hospital between January 2001 and July 2017 was respectively reviewed. Results: Eighteen patients with histology-proven LYH (13 females and 5 males ) were identified. All lymphocytic adenohypophysitis (LAH) were females(n=6), two of whom were associated with pregnancy. Eleven patients (6 females and 5 males) had lymphocytic panhypophysitis (LPH) and one(female) had hypothalamitis...
January 9, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29341525/-general-internal-medicine%C3%A2-2017-scientific-breakthroughs-in-ambulatory-care
#13
Alexandre Gouveia, Lionel De Alencastro, Yvonne Fierz, Lionel Koehli, Alexandre Béguelin, Olivier Pasche, Kevin Selby, Patrick Bodenmann
Bariatric surgery improves glycemic control in obese patients with diabetes type 2. Dual antiplatelet therapy can be maintained beyond 12 months after a myocardial infarction. Levothyroxine is not beneficial among patients ≥ 65 years that have subclinical hypothyroidism. Prophylactic anticoagulation in lower limb immobilisation should be reserved only for patients with a high risk of thromboembolism. A diagnosis of asthma should be initially confirmed by a spirometry if clinically suspected. A proton pump inhibitor is indicated for patients ≥ 65 years that are treated with aspirin...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341448/beneficial-actions-of-microbiota-derived-tryptophan-metabolites
#14
REVIEW
J J Galligan
Tryptophan is an important dietary amino acid and it is the precursor for 5-hydroxytryptamine synthesis in the nervous system and by enterochromaffin cells in the gut mucosa. Tryptophan is also metabolized by enzymes in the gut mucosa and also by enzymes produced by the gut microbiome. Diet and the microbiome can contribute to metabolic disease in part by causing intestinal inflammation and increased permeability. In this issue of Neurogastroenterology and Motility, Jennis et al. test the hypothesis that indole tryptophan metabolites produced by gut bacteria might be responsible for the anti-inflammatory and beneficial metabolic effects of the gut microbiome and Roux-en-Y gastric bypass surgery for weight loss by obese patients...
February 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29340680/association-of-bariatric-surgery-vs-medical-obesity-treatment-with-long-term-medical-complications-and-obesity-related-comorbidities
#15
Gunn Signe Jakobsen, Milada Cvancarova Småstuen, Rune Sandbu, Njord Nordstrand, Dag Hofsø, Morten Lindberg, Jens Kristoffer Hertel, Jøran Hjelmesæth
Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340678/lifestyle-intervention-and-medical-management-with-vs-without-roux-en-y-gastric-bypass-and-control-of-hemoglobin-a1c-ldl-cholesterol-and-systolic-blood-pressure-at-5-years-in-the-diabetes-surgery-study
#16
COMMENT
Sayeed Ikramuddin, Judith Korner, Wei-Jei Lee, Avis J Thomas, John E Connett, John P Bantle, Daniel B Leslie, Qi Wang, William B Inabnet, Robert W Jeffery, Keong Chong, Lee-Ming Chuang, Michael D Jensen, Adrian Vella, Leaque Ahmed, Kumar Belani, Charles J Billington
Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340677/association-of-bariatric-surgery-using-laparoscopic-banding-roux-en-y-gastric-bypass-or-laparoscopic-sleeve-gastrectomy-vs-usual-care-obesity-management-with-all-cause-mortality
#17
Orna Reges, Philip Greenland, Dror Dicker, Morton Leibowitz, Moshe Hoshen, Ilan Gofer, Laura J Rasmussen-Torvik, Ran D Balicer
Importance: Bariatric surgery is an effective and safe approach for weight loss and short-term improvement in metabolic disorders such as diabetes. However, studies have been limited in most settings by lack of a nonsurgical group, losses to follow-up, missing data, and small sample sizes in clinical trials and observational studies. Objective: To assess the association of 3 common types of bariatric surgery compared with nonsurgical treatment with mortality and other clinical outcomes among obese patients...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340555/the-role-of-the-sleeve-gastrectomy-and-the-management-of-type-2-diabetes
#18
Taíse Fuchs, Marcelo Loureiro, Gabriela Heloise Both, Heloise Helena Skraba, Thaís Andrade Costa-Casagrande
BACKGROUND: Currently, bariatric surgery has promoted weight loss and improved glycemic control in obese patients through different techniques, including vertical sleeve gastrectomy. AIM: Present and update the different vertical sleeve gastrectomy ways of action, both in the treatment of obesity and diabetes, approaching its potential effect on gastrointestinal physiology, as well as the benefits achieved by this manipulation. METHODS: Pubmed database search was used crossing the headings: obesity, type 2 diabetes and sleeve gastrectomy...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29339445/bile-acids-in-glucose-metabolism-in-health-and-disease
#19
REVIEW
Hagit Shapiro, Aleksandra A Kolodziejczyk, Daniel Halstuch, Eran Elinav
Bile acids (BAs) are cholesterol-derived metabolites that facilitate the intestinal absorption and transport of dietary lipids. Recently, BAs also emerged as pivotal signaling molecules controlling glucose, lipid, and energy metabolism by binding to the nuclear hormone farnesoid X receptor (FXR) and Takeda G protein receptor 5 (TGR5) in multiple organs, leading to regulation of intestinal incretin secretion, hepatic gluconeogenesis, glycogen synthesis, energy expenditure, inflammation, and gut microbiome configuration...
January 16, 2018: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29339031/resolution-of-type-2-diabetes-after-sleeve-gastrectomy-a-2-step-hypothesis
#20
Federico Sista, Valentina Abruzzese, Marco Clementi, Stefano Guadagni, Laura Montana, Sergio Carandina
BACKGROUND: Weight loss (WL) and altered gut hormonal levels are involved in glucose homeostasis after laparoscopic sleeve gastrectomy (LSG). OBJECTIVES: The aim of this study was to evaluate the time-related effects of WL, ghrelin, and glucacon-like peptide-1 (GLP-1) plasma concentrations on type 2 diabetes resolution after LSG. SETTING: University hospital, Italy. METHODS: Ninety-one patients who underwent LSG were investigated...
December 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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