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Diabetes anesthesia

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https://www.readbyqxmd.com/read/28058148/pain-perception-in-phacoemulsification-with-topical-anesthesia-and-evaluation-of-factors-related-with-pain
#1
Zeynep Dadacı, Mehmet Borazan, Nurşen Öncel Acır
OBJECTIVES: Evaluation of pain during and after phacoemulsification with topical anesthesia in patients with senile cataract and investigation of factors related with pain. MATERIALS AND METHODS: Ninety-two adult patients scheduled for routine clear corneal phacoemulsification with topical anesthesia who had no previous cataract surgery in their fellow eyes were included in the study. Verbal pain scale and visual analog scale were used to measure pain intensity...
August 2016: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28050987/glucose-levels-and-hemodynamic-changes-in-patients-submitted-to-routine-dental-extraction-under-local-anesthesia-with-and-without-adrenaline
#2
Sanjay Byakodi, Vivek Gurjar, Sushant Soni
INTRODUCTION: In maxillofacial surgery, the simplest procedure that we perform is dental extraction. However, this simple procedure is challenged by the patient's poor medical condition. We generally use local anesthesia in combination with adrenaline; however, as we come across patients with diabetes mellitus and cardiovascular diseases who seek dental extraction, we need to be doubly cautious while using adrenaline. In this study, we intend to compare the effects of local anesthesia with adrenaline and local anesthesia without adrenaline on hemodynamic changes (blood pressure and pulse rate) and random blood sugar levels...
January 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28045725/utilization-of-stand-by-extracorporeal-membrane-oxygenation-in-a-high-risk-parturient-with-methamphetamine-associated-cardiomyopathy-undergoing-dilation-and-evacuation-a-case-report
#3
Cesar Padilla, Antonio Hernandez Conte, Danny Ramzy, Lorraine Lubin, Troy LaBounty, Judith H Chung, Ying Zeng
Parturients may present with evidence of acute heart failure or respiratory distress during the peripartum period. This case report documents utilization of "stand-by" extracorporeal membrane oxygenation (ECMO) for a 40-year-old woman with a history of severe left ventricular dysfunction who presented for elective dilation and evacuation of triplets at 20 weeks' gestation. The patient's medical history was significant for hypertension, diabetes mellitus, methamphetamine use (acute/chronic), and cardiac-respiratory arrest before her previous emergent cesarean delivery...
December 30, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/28017292/bullosis-diabeticorum-in-a-young-child-case-report-of-a-very-rare-entity-and-a-literature-review
#4
Anca Chiriac, Irina Costache, Cristian Podoleanu, Adrian Naznean, Simona Stolnicu
Bullosis diabeticorum (BD), or diabetic bulla, is 1 of the cutaneous manifestations of diabetes mellitus, reported in 0.5% of people with diabeties in the United States, mostly in adult men who have had long-lasting and uncontrolled diabetes associated with diabetic peripheral neuropathy. However, BD in young children is a mostly unrecognized entity. We present a case of BD in a 3-year-old girl with type 1 diabetes mellitus who had been treated with insulin for 7 months prior to hospitalization. Dermatologic examination revealed a large, tense bulla filled with clear fluid and not associated with pain or pruritus, localized on the lateral margin of the right hand...
December 21, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28005257/safety-of-transsphenoidal-microsurgical-approach-in-patients-with-an-acth-secreting-pituitary-adenoma
#5
Carmine Antonio Donofrio, Marco Losa, Marco Gemma, Lodoviga Giudice, Lina Raffaella Barzaghi, Pietro Mortini
PURPOSE: Patients affected by Cushing's disease often have important comorbidities directly linked to hypercortisolism that might enhance the operative risk. We report the safety of transsphenoidal surgery in patients affected by Cushing's disease as compared with patients with nonfunctioning pituitary adenoma. METHODS: We have retrospectively analyzed 142 patients with Cushing's disease and 299 patients with nonfunctioning pituitary adenoma who underwent transsphenoidal surgery performed by a single experienced neurosurgeon between September 2007 and December 2014...
December 22, 2016: Endocrine
https://www.readbyqxmd.com/read/28002212/ambulatory-surgical-centers-a-review-of-complications-and-adverse-events
#6
Charles A Goldfarb, Anchal Bansal, Robert H Brophy
An increasing number of orthopaedic surgeries are performed at ambulatory surgical centers (ASCs), as is exemplified by the 272% population-adjusted increase in outpatient rotator cuff repairs from 1996 to 2006. Outpatient surgery is convenient for patients and cost effective for the healthcare system. The rate of complications and adverse events following orthopaedic surgeries at ASCs ranges from 0.05% to 20%. The most common complications are pain and nausea, followed by infection, impaired healing, and bleeding; these are affected by surgical and patient risk factors...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27990829/-islet-transplantation-as-a-treatment-for-hypoglycemia-unawareness-syndrome-evaluation-of-the-pilot-program-and-comparison-with-pancreas-transplantation
#7
Martina Zahradnická, Peter Girman, Jan Kříž, Zuzana Berková, Tomáš Koblas, Ema Vávrová, Lucie Kosinová, David Habart, Eva Fábryová, Eva Dovolilová, Tomáš Neškudla, Jan Peregrin, Jozef Kováč, Květoslav Lipár, Matěj Kočík, Lenka Németová, Jiří Svoboda, František Saudek
Islet transplantation (ITx) started in 2005 in IKEM as a potentially safer alternative to pancreas transplantation (PTx), which so far had represented the method of choice in type-1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. The aim of the study was to compare these two methods with regard to severe hypoglycemia elimination and to frequency of complications.Up to November 2015 a total number of 48 patients underwent ITx. The results from 22 patients with hypoglycemia unawareness were statistically analyzed...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27973934/patients-with-type-2-diabetes-anesthetic-management-in-the-ambulatory-setting-part-1-pathophysiology-and-associated-disease-states
#8
Bryant W Cornelius
The increasing prevalence of diabetes mellitus in the general population has many implications for the ambulatory anesthesia provider. Complications, particularly associated with poor glycemic control, can affect multiple organ systems and jeopardize the safety of any planned anesthetic. It is essential that anesthesiologists and sedation providers have in-depth knowledge of the pathophysiology of diabetes mellitus and the comorbid conditions that commonly accompany it. Anesthesiologists and sedation providers must also understand certain surgical and anesthetic considerations when planning an effective and safe anesthetic for diabetic patients...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27752032/starvation-ketoacidosis-as-a-cause-of-unexplained-metabolic-acidosis-in-the-perioperative-period
#19
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
#20
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
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