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Fasting And surgery

Anna Solini, Marta Seghieri, Eleonora Santini, Livia Giannini, Edoardo Biancalana, Stefano Taddei, Duccio Volterrani, Rosa Maria Bruno
OBJECTIVE: Bariatric surgery may ameliorate renal function through vascular mechanisms. This study tested surgery's ability to improve measured glomerular filtration rate (mGFR) and identified clinical, renal, and systemic vascular predictors of such improvement. METHODS: Twenty-five nondiabetic subjects with severe obesity were studied before and 1 year after Roux-en-Y gastric bypass, evaluating mGFR and renal plasma flow, basal renal resistive index (RI) and dynamic renal RI, renal visceral fat, and systemic vascular parameters, including flow-mediated dilation, aortic pulse wave velocity, and carotid intima media thickness and stiffness...
December 5, 2018: Obesity
Andrew Davies, Wei Sheng Pang, Timothy Fowler, Ffion Dewi, Thomas Wright
Preoperative fasting is necessary to reduce the risk of regurgitation of gastric contents and pulmonary aspiration in patients undergoing general anaesthetic and procedural sedation. Excessive fasting is associated with metabolic, cardiovascular and gastrointestinal complications and patient discomfort. We aimed to reduce the fasting time for patients on the plastic surgery trauma list. Adult inpatients awaiting surgery were asked to complete a preoperative assessment sheet. Questions included the length of preoperative fasting, clarity of instructions and wellness scores...
2018: BMJ Open Quality
John P Andrews, Abhijeet Gummadavelli, Pue Farooque, Jennifer Bonito, Christopher Arencibia, Hal Blumenfeld, Dennis D Spencer
Importance: Seizures recur in as many as half of patients who undergo surgery for drug-resistant temporal lobe epilepsy (TLE). Understanding why TLE is resistant to surgery in some patients may reveal insights into epileptogenic networks and direct new therapies to improve outcomes. Objective: To characterize features of surgically refractory TLE. Design, Setting, and Participants: Medical records from a comprehensive epilepsy center were retrospectively reviewed for 131 patients who received a standard anteromedial temporal resection by a single surgeon from January 1, 2000, to December 31, 2015...
December 3, 2018: JAMA Neurology
Mahmoud Ismail, Dania Nachira, Elisa Meacci, Gian Maria Ferretti, Marc Swierzy, Julianna Paulina Englisch, Ramin Raul Ossami Saidy, Svea Faber, Maria Teresa Congedo, Marco Chiappetta, Leonardo Petracca Ciavarella, Stefano Margaritora, Jens C Rueckert
Background: The efficacy of video-assisted thoracic surgery (VATS) in the treatment of pleural empyema has recently been proven. Till today, very few works evaluated the role of uniportal-VATS (U-VATS) approach in the treatment of pleural empyema even if it currently represents the most innovative and less invasive thoracoscopic approach. We report our experience with U-VATS in the treatment of pleural empyema. Methods: A retrospective bicentric analysis of 35 consecutive patients who underwent surgical treatment of stage II and stage III pleural empyema was performed, from January 2015 to May 2017...
November 2018: Journal of Thoracic Disease
Michel Gonzalez, Etienne Abdelnour-Berchtold, Jean Yannis Perentes, Valérie Doucet, Mathieu Zellweger, Carlos Marcucci, Hans-Beat Ris, Thorsten Krueger, Fabrizio Gronchi
Background: Enhanced recovery after surgery (ERAS) programs have been reported to decrease complications and shorten hospital stays after lung resections, but their implementation requires time and financial investment with dedicated staff. The aim of this study was to evaluate the clinical and economic outcomes of video-assisted thoracoscopic surgery (VATS) anatomical pulmonary resections before and after implementation of an ERAS program. Methods: The first 50 consecutive patients undergoing VATS lobectomy or segmentectomy for malignancy after implementation of an ERAS program were compared with 50 consecutive patients treated before its introduction...
October 2018: Journal of Thoracic Disease
Fiona Louis, Shiro Kitano, João F Mano, Michiya Matsusaki
Although adipose tissue is one of the most abundant tissues of the human body, its reconstruction remains a competitive challenge. The conventional in vitro two or three-dimensional (2D or 3D) models of mature adipocytes unfortunately lead to their quick dedifferentiation after one week, and complete differentiation of adipose derived stem cells (ADSC) usually requires more than one month. In this context, we developed biomimetic 3D adipose tissues with high density collagen by mixing type I collagen microfibers with primary mouse mature adipocytes or human ADSC in transwells...
November 28, 2018: Acta Biomaterialia
Heide-Katharina Bauer, Daniela Flesch, Stefan Walenta, Ronald E Unger, Roxana Schwab, Sandra Nezi-Cahn, Annette Hasenburg, Martin Heller, Walburgis Brenner
BACKGROUND: Our aim was to establish a reliable protocol for the isolation of primary human oral mucosa epithelial cells that ensured a successful, efficient and reproducible cell culture for the utilization in subsequent experiments and for tissue engineering purposes. Therefore, we analyzed and evaluated various isolation routines and cultivation protocols. Furthermore, we investigated the functionality of isolated epithelial cells for tissue engineering approaches in an in vitro mucosa equivalent cell culture model system...
December 1, 2018: Tissue Engineering. Part C, Methods
W J Fawcett, M Thomas
It is widely recognised that prolonged fasting for elective surgery in both children and adults serves no purpose, adversely affects patient well-being and can be detrimental. Although advised fasting times for solids remain unchanged, there is good evidence to support a 1-h fast for children, with no increase in risk of pulmonary aspiration. In adults, a major focus has been the introduction of carbohydrate loading before anaesthesia, so that patients arrive for surgery not only hydrated but also in a more normal metabolic state...
November 30, 2018: Anaesthesia
Tianwei Xia, Fei Yu, Kaijia Zhang, Zongfang Wu, Dongquan Shi, Huajian Teng, Jirong Shen, Xianfeng Yang, Qing Jiang
Background: Intraarticular injection of the mesenchymal stem cells (MSCs) has shown to be successful for treating osteoarthritis (OA). Nevertheless, many studies have been focusing on autologous MSCs. The following study investigates the safety and effectiveness of intraarticular injection of allogenic MSCs in a pig OA model. Methods: Superparamagnetic iron oxide (SPIO) nanoparticles were labelled with bone marrow-derived mesenchymal stem cells (BM-MSCs) to allow cells tracking using magnetic resonance imaging (MRI)...
October 2018: Annals of Translational Medicine
Deepak Dhamnetiya, Manish Kumar Goel, BalRaj Dhiman, Om Prakash Pathania
INTRODUCTION: Gallstone disease (GSD) represents a significant burden for health-care systems worldwide and is one of the most common disorders among patients presenting to emergency rooms with abdominal discomfort. This study was aimed to know the association of biochemical parameters and development of GSD. MATERIALS AND METHODS: We conducted a case-control study from January 2013 to December 2013 among patients attending outpatient department of general surgery at a tertiary care hospital of Delhi, North India; we recruited 120 cases and the same number of controls in the study...
October 2018: Journal of Laboratory Physicians
Bolin Liu, Yuan Wang, Shujuan Liu, Tianzhi Zhao, Binfang Zhao, Xue Jiang, Lin Ye, Lanfu Zhao, Wenhai Lv, Yufu Zhang, Tao Zheng, Yafei Xue, Lei Chen, Long Chen, Yingxi Wu, Zhengmin Li, Jing Yan, Shasha Wang, Xude Sun, Guodong Gao, Yan Qu, Shiming He
OBJECT: The aim of this study was to evaluate the effect of preoperative oral carbohydrate loading versus fasting on the outcomes of patients undergoing elective craniotomy. METHODS: In a single-center randomized controlled study, 120 neurosurgical patients who were admitted for elective craniotomy were included and randomized into 2 groups: 58 patients received 400 mL of oral carbohydrate loading 2 h before surgery (intervention group), and 62 patients were fasting for 8 h prior to surgery as routine management (control group)...
November 17, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Pablo Padilla, Priscilla Ly, Rachel Dillard, Stefanos Boukovalas, Ramon Zapata-Sirvent, Linda G Phillips
BACKGROUND: Medical tourism has become increasingly globalized as individuals travel abroad to receive medical care. Cosmetic patients in particular are more likely to seek surgery abroad to defray costs. Unfortunately, not all procedures performed abroad adhere to strict hygienic regulations, and bacterial flora vary. As a result, it is not uncommon for consumers to return home with difficult-to-treat postoperative infections. METHODS: A systematic literature review of PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was performed to assess the microbiology patterns and medical management of patients with postoperative infections after undergoing elective surgery abroad...
December 2018: Plastic and Reconstructive Surgery
Matilde Rubio-Almanza, Rosa Cámara-Gómez, David Hervás-Marín, José Luis Ponce-Marco, Juan Francisco Merino-Torres
BACKGROUND: Bariatric surgery is effective in remission of obesity comorbidities. This study was aimed at comparing CVD risk between morbidly obese patients with type 2 diabetes and pre-diabetes before and after bariatric surgery as well as assessing comorbidities. METHODS: This is a retrospective observational study with 105 patients with type 2 diabetes (DMbaseline) and prediabetes (preDMbaseline) who underwent Roux-en-Y gastric bypass. Data were collected preoperative and then at 3,6,12,18,24,36,48, and 60 months after surgery...
November 28, 2018: BMC Endocrine Disorders
Ali Alomari, Christian Jaspers, Wolf-Dieter Reinbold, Joachim Feldkamp, Ulrich J Knappe
BACKGROUND: Perisellar infiltration may be responsible for incomplete removal of pituitary tumors. Since intraoperative visualization of parasellar structures is difficult during transsphenoidal surgery, we are describing the use of intraoperative direct contact ultrasound (IOUS). METHODS: Within 5 years, in 113 transsphenoidal operations (58 male, 55 female, age 14-81 years, 110 pituitary adenomas (mean diameter 26.6 mm, 69 non-secreting adenomas, 41 secreting adenomas), and 1 of each Rathke's cleft cyst, craniopharyngioma, and xanthogranuloma), IOUS was applied...
November 27, 2018: Acta Neurochirurgica
Reyhaneh Farrokhi Yekta, Mostafa Rezaei Tavirani, Afsaneh Arefi Oskouie, Mohammad Reza Mohajeri-Tehrani, Ahmad Reza Soroush, Alireza Akbarzadeh Baghban
Objectives: As the most prevalent endocrine system malignancy, papillary thyroid carcinoma had a very fast rising incidence in recent years for unknown reasons besides the fact that the current methods in thyroid cancer diagnosis still hold some limitations. Therefore, the aim of this study was to improve the potential molecular markers for diagnosis of benign and malignant thyroid nodules to prevent unnecessary surgeries for benign tumors. Materials and Methods: In this study, 1H-NMR metabolomics platform was used to seek the discriminating serum metabolites in malignant papillary thyroid carcinoma (PTC) compared to benign multinodular goiter (MNG) and healthy subjects and also to better understand the disease mechanisms using bioinformatics analysis...
November 2018: Iranian Journal of Basic Medical Sciences
I Stafeev, N Podkuychenko, S Michurina, I Sklyanik, A Panevina, E Shestakova, K Yah'yaev, V Fedenko, E Ratner, A Vorotnikov, M Menshikov, Y Yashkov, Ye Parfyonova, M Shestakova
BACKGROUND: Obesity and type 2 diabetes mellitus (T2DM) are among the most important morbidity factors. In this study we tested the hypothesis that low proliferative potential of adipose derived stromal cells (ADSC) associates with reduced formation of new fat depots, excess accumulation of fat in the functional adipocytes and their hypertrophy, resulting in fat inflammation and insulin resistance. METHODS: We screened two groups of obese patients with or without T2DM, matched for BMI, age, and duration of obesity to test the hypothesis that hypertrophy and decreased renewal of adipocytes may underlie transition from obesity to T2DM...
November 4, 2018: Journal of Diabetes and its Complications
Yoann Bohu, Shahnaz Klouche, Serge Herman, Olivier de Pamphilis, Antoine Gerometta, Nicolas Lefevre
BACKGROUND: The rate of septic arthritis in the knee after anterior cruciate ligament (ACL) reconstruction varies in the literature but is generally less than 1%. It has been reported to be higher in professional athletes (5.7%). PURPOSE: The primary goal was to evaluate the rate of septic arthritis after ACL reconstruction in professional athletes compared with other patients. The secondary goals were to analyze the risk factors; increased cost of infections; return to sport, satisfaction, and functional results at 1-year follow-up; and resolution rate of infections at final follow-up...
November 27, 2018: American Journal of Sports Medicine
Federico Sista, Valentina Abruzzese, Stefano Guadagni, Sergio Carandina, Marco Clementi
Background: Our aim is to evaluate the effects of High Resected Gastric Volume(HRGV) on poorly Type 2 Diabetes Mellitus(DM2) after Laparoscopic Sleeve Gastrectomy(LSG). Methods: 256 patients were divided into two groups according to the RGV: < 1500 mL(Group A: 131 pts) and > 1500 mL(Group B: 147 pts). % excess body mass index loss (%EBMIL), Fasting Blood Glucose (FBG), HbA1c, C peptide were assessed before surgery and at the 3rd day, 6th,12th,24th,36th month after LSG...
December 2018: Annals of Medicine and Surgery
Aliza S Alter, Ravi Dhamija, Tiffani L McDonough, Stephie Shen, Danielle K McBrian, Arthur M Mandel, Guy M McKhann, Neil A Feldstein, Cigdem I Akman
AIMS: We aimed to classify ictal onset patterns (IOPs) in pediatric patients undergoing intracranial electroencephalography (IEEG) to guide surgery for refractory epilepsy. We aimed to determine if morphology of IOPs can predict surgical outcome. MATERIALS AND METHODS: We performed a retrospective review of pediatric patients who underwent epilepsy surgery guided by subdural IEEG from 2007 to 2016. IEEG seizures were reviewed by a blinded epileptologist. Data was collected on outcomes...
October 28, 2018: Epilepsy Research
Hakan Özer, İbrahim Aslan, Mehmet Tahir Oruç, Yaşar Çöpelci, Ebru Afşar, Sabriye Kaya, Mutay Aslan
BACKGROUND: This study aimed to determine early postoperative changes of serum sphingomyelin (SM) and ceramide (CER) species following laparoscopic sleeve gastrectomy (LSG). METHODS: Twenty obese patients [mean body mass index (BMI) 45,64 ± 6,10 kg/m2 ] underwent LSG and normal weight control patients (mean BMI 31,51 ± 6,21 kg/m2 ) underwent laparoscopic cholecystectomy. Fasting blood samples were collected prior to surgery, at day 1 and day 30 after surgery...
November 24, 2018: Lipids in Health and Disease
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