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Glycemic control operation

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https://www.readbyqxmd.com/read/28846534/the-skeleton-in-the-closet-harvesting-a-skeletonized-ima
#1
Curtis G Tribble
There is a considerable amount of data that using more than one arterial graft provides a survival advantage for patients undergoing coronary bypass operations. The Society of Thoracic Surgeons has a set of official guidelines for the use of arterial grafts which include the following recommendations:Internal mammary arteries (IMA's) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated.As an adjunct to left internal mammary artery (LIMA), a second arterial graft (right IMA or radial artery [RA]) should be considered in appropriate patients...
August 28, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28836877/management-of-hyperglycemia-in-the-neurosurgery-patient
#2
Rene Daniel, Satya Villuri, Kevin Furlong
Hyperglycemia is associated with adverse outcomes in patients who are candidates for or underwent neurosurgical procedures. Specific concerns and settings that relate to these patients are preoperative glycemic control, intraoperative control, management in the neurological intensive care unit (NICU), and postoperative control. In each of these settings, physicians have to ensure appropriate glycemic control to prevent or minimize adverse events. The glycemic control is usually managed by a neurohospitalist in co-management with the neurosurgery team pre- and post-operatively, and by the neurocritical care team in the setting of NICU...
August 30, 2017: Hospital Practice (Minneapolis)
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/28815303/effect-of-barley-supplementation-on-the-fecal-microbiota-caecal-biochemistry-and-key-biomarkers-of-obesity-and-inflammation-in-obese-db-db-mice
#4
Jose F Garcia-Mazcorro, David A Mills, Kevin Murphy, Giuliana Noratto
PURPOSE: Barley is a low-glycemic index grain that can help diabetic and obese patients. The effect of barley intake depends on the host and the associated gut microbiota. This study investigated the effect of barley intake on the fecal microbiota, caecal biochemistry, and key biomarkers of obesity and inflammation. METHODS: Obese db/db mice were fed diets with and without barley during 8 weeks; lean mice were used as lean controls. Fecal microbiota was evaluated using 16S marker gene sequencing in a MiSeq instrument; several markers of caecal biochemistry, obesity, and inflammation were also evaluated using standard techniques...
August 16, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28811796/visual-outcome-after-phacoemulsification-with-lens-implant-in-diabetic-and-non-diabetic-patients-a-comparative-study
#5
Abdul Rashid Shaikh, Abdul Haleem Mirani, Muhammad Saleh Memon, Muhammad Faisal Fahim
OBJECTIVE: To compare the visual outcomes of phacoemulsification surgery with intraocular lens (IOL) in persons with and without diabetes at end of follow-up. METHODS: This was a comparative, cross sectional, observational study with Non-probability, purposive sampling. After approval from "Research Ethical Committee of Isra Post-graduate Institute of Ophthalmology Karachi, 92 patients with cataract in one eye were selected. Patients were divided into two groups...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#6
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/28717914/association-of-elevated-pre-operative-hemoglobin-a1c-and-post-operative-complications-in-non-diabetic-patients-a-systematic-review
#7
REVIEW
Negar Karimian, Petru Niculiseanu, Alexandre Amar-Zifkin, Francesco Carli, Liane S Feldman
IMPORTANCE: Pre-operative hyperglycemia is associated with post-operative adverse outcomes in diabetic and non-diabetic patients. Current pre-operative screening includes random plasma glucose, yet plasma glycated hemoglobin (HbA1c) is a better measure of long-term glycemic control. It is not clear whether pre-operative HbA1c can identify non-diabetic patients at risk of post-operative complications. OBJECTIVE: The systematic review summarizes the evidence pertaining to the association of suboptimal pre-operative HbA1c on post-operative outcomes in adult surgical patients with no history of diabetes mellitus...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28713862/metabolic-surgery-gastric-bypass-for-the-treatment-of-type-2-diabetes-mellitus
#8
REVIEW
Maria Del Pilar Quevedo, Mariano Palermo, Edgardo Serra, Marianela A Ackermann
Type 2 diabetes mellitus (T2DM) is one of the largest health emergencies of the 21st century given the worldwide increase of obesity during the last decades and its close association. T2DM is an inherited, polygenic and chronic disease caused by the interaction between several genetic variants in genes and the environment. The continuous search for new and more effective tools to achieve appropriate glycemic control became imperative in order to reduce long-term complications and mortality rates related to T2DM...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28698280/glycemic-control-after-metabolic-surgery-a-granger-causality-and-graph-analysis
#9
Elena Previti, Serenella Salinari, Alessandro Bertuzzi, Esmeralda Capristo, Stefan Bornstein, Geltrude Mingrone
To examine the contribution of Non-Esterified Fatty-Acids (NEFA) and incretin to insulin-resistance and diabetes amelioration after malabsorptive metabolic-surgery that dramatically reduces circulating NEFA. In fact, NEFA infusion reduces glucose-stimulated insulin secretion and high-fat diets predict diabetes development. Six healthy-controls, 11 obese and 10 Type-2-Diabetic (T2D) subjects were studied before and 1 month after Bilio-Pancreatic Diversion (BPD). Twenty-four hours plasma glucose, NEFA, insulin, C-peptide, glucagon-like peptide-1 (GLP1) and gastric-inhibitory-polypeptide (GIP) time courses were obtained and analyzed by Granger causality and graph analyses...
July 11, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28582271/preoperative-oral-carbohydrate-load-versus-placebo-in-major-elective-abdominal-surgery-procy-a-randomized-placebo-controlled-multicenter-phase-iii-trial
#10
Luca Gianotti, Roberto Biffi, Marta Sandini, Daniele Marrelli, Andrea Vignali, Riccardo Caccialanza, Jacopo Viganò, Annarita Sabbatini, Giulio Di Mare, Mario Alessiani, Francesco Antomarchi, Maria Grazia Valsecchi, Davide P Bernasconi
OBJECTIVE: To explore whether preoperative oral carbohydrate (CHO) loading could achieve a reduction in the occurrence of postoperative infections. BACKGROUND: Hyperglycemia may increase the risk of infection. Preoperative CHO loading can achieve postoperative glycemic control. METHODS: This was a randomized, controlled, multicenter, open-label trial. Nondiabetic adult patients who were candidates for elective major abdominal operation were randomized (1:1) to a CHO (preoperative oral intake of 800 mL of water containing 100 g of CHO) or placebo group (intake of 800 mL of water)...
June 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28557817/accuracy-of-capillary-and-arterial-whole-blood-glucose-measurements-using-a-glucose-meter-in-patients-under-general-anesthesia-in-the-operating-room
#11
Brad S Karon, Leslie J Donato, Chelsie M Larsen, Lindsay K Siebenaler, Amy E Wells, Christina M Wood-Wentz, Mary E Shirk-Marienau, Timothy B Curry
BACKGROUND: The aim of this study was to evaluate the use of a glucose meter with surgical patients under general anesthesia in the operating room. METHODS: Glucose measurements were performed intraoperatively on 368 paired capillary and arterial whole blood samples using a Nova StatStrip (Nova Biomedical, USA) glucose meter and compared with 368 reference arterial whole blood glucose measurements by blood gas analyzer in 196 patients. Primary outcomes were median bias (meter minus reference), percentage of glucose meter samples meeting accuracy criteria for subcutaneous insulin dosing as defined by Parkes error grid analysis for type 1 diabetes mellitus, and accuracy criteria for intravenous insulin infusion as defined by Clinical and Laboratory Standards Institute guidelines...
September 2017: Anesthesiology
https://www.readbyqxmd.com/read/28541890/event-triggered-model-predictive-control-for-embedded-artificial-pancreas-systems
#12
Ankush Chakrabarty, Stamatina Zavitsanou, Francis Doyle Iii, Eyal Dassau
OBJECTIVE: The development of artificial pancreas (AP) technology for deployment in low-energy, embedded devices is contingent upon selecting an efficient control algorithm for regulating glucose in people with type 1 diabetes mellitus (T1DM). In this paper, we aim to lower the energy consumption of the AP by reducing controller updates, that is, the number of times the decision-making algorithm is invoked to compute an appropriate insulin dose. METHODS: Physiological insights into glucose management are leveraged to design an event-triggered model predictive controller (MPC) that operates efficiently, without compromising patient safety...
May 23, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28534188/outcomes-of-one-anastomosis-gastric-bypass-in-472-diabetic-patients
#13
Osama Taha, Mahmoud Abdelaal, Mohamed Abozeid, Awny Askalany, Mohamed Alaa
BACKGROUND: The positive impact of Roux-en-Y gastric bypass (RYGB) on metabolic syndrome and glycemic control has been proven in obese patients. One anastomosis gastric bypass (OAGB) is a simple, effective and easy to learn procedure. OAGB provides encouraging results for the treatment of diabetes obese patients, but does it have the ability to be an alternative procedure to RYGB in the treatment of these patients? The aim of this study is to evaluate the outcomes of OAGB on diabetic obese patients at the bariatric centre of our university hospital...
May 22, 2017: Obesity Surgery
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
#14
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/28531992/boronate-functionalized-hydrogel-as-a-novel-biosensing-interface-for-the-glycated-hemoglobin-a1c-hba1c-based-on-the-competitive-binding-with-signaling-glycoprotein
#15
Yong Duk Han, Ka Ram Kim, Yoo Min Park, Seung Yeon Song, Yong Ju Yang, Kangsun Lee, Yunhee Ku, Hyun C Yoon
According to recent increases in public healthcare costs associated with diabetes mellitus, the development of new glycemic monitoring techniques based on the biosensing of glycated hemoglobin A1c (HbA1c), a promising long-term glycemic biomarker, has become a major challenge. In the development of HbA1c biosensors for point-of-care applications, the selection of an effective biorecognition layer that provides a high reaction yield and specificity toward HbA1c is regarded as the most significant issue. To address this, we developed a novel HbA1c biosensing interfacial material by the integration of boronate hydrogel with glass fiber membrane...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28477035/increased-%C3%AE-cell-mass-in-obese-rats-after-gastric-bypass-a-potential-mechanism-for-improving-glycemic-control
#16
Shuping Zhang, Wei Guo, Jinshan Wu, Lilin Gong, Qifu Li, Xiaoqiu Xiao, Jun Zhang, Zhihong Wang
BACKGROUND Over the past few decades, bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), has become widely considered the most effective treatment for morbid obesity. In most cases, it results in enhanced glucose management in patients with obesity and type 2 diabetes (T2D), which is observed before significant weight loss. However, what accounts for this effect remains controversial. To gain insight into the benefits of RYGB in T2D, we investigated changes in the β-cell mass of obese rats following RYGB...
May 6, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28467526/centers-for-disease-control-and-prevention-guideline-for-the-prevention-of-surgical-site-infection-2017
#17
Sandra I Berríos-Torres, Craig A Umscheid, Dale W Bratzler, Brian Leas, Erin C Stone, Rachel R Kelz, Caroline E Reinke, Sherry Morgan, Joseph S Solomkin, John E Mazuski, E Patchen Dellinger, Kamal M F Itani, Elie F Berbari, John Segreti, Javad Parvizi, Joan Blanchard, George Allen, Jan A J W Kluytmans, Rodney Donlan, William P Schecter
Importance: The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. Objective: To provide new and updated evidence-based recommendations for the prevention of SSI...
August 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28459844/a-predictive-model-for-lack-of-partial-clinical-remission-in-new-onset-pediatric-type-1-diabetes
#18
Katherine R Marino, Rachel L Lundberg, Aastha Jasrotia, Louise S Maranda, Michael J Thompson, Bruce A Barton, Laura C Alonso, Benjamin Udoka Nwosu
IMPORTANCE: >50% of patients with new-onset type 1 diabetes (T1D) do not enter partial clinical remission (PCR); early identification of these patients may improve initial glycemic control and reduce long-term complications. AIM: To determine whether routinely obtainable clinical parameters predict non-remission in children and adolescents with new-onset T1D. SUBJECTS AND METHODS: Data on remission were collected for the first 36 months of disease in 204 subjects of ages 2-14 years with new-onset type 1 diabetes...
2017: PloS One
https://www.readbyqxmd.com/read/28448204/future-research-opportunities-in-peri-prosthetic-joint-infection-prevention
#19
Elie Berbari, John Segreti, Javad Parvizi, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28433465/dumping-symptoms-is-triggered-by-fat-as-well-as-carbohydrates-in-patients-operated-with-roux-en-y-gastric-bypass
#20
Anna Laurenius, Malin Werling, Carel W le Roux, Lars Fändriks, Torsten Olbers
BACKGROUND: Dumping syndrome after Roux-en-Y gastric bypass (RYGB) is traditionally associated with the consumption of refined carbohydrates, but the role of dietary fat is unclear. OBJECTIVES: This study compares symptoms after consumption of a carbohydrate-rich or fat-rich beverage to determine perceived symptoms, glycemic control, and pulse rate. SETTING: University hospital. METHODS: We assessed perceived symptoms (Sigstad's Dumping Index) and glycemic control (P-glucose and S-insulin) as well as autonomic nervous system activity (reflected by arterial pulse rate) after a standardized liquid meal test (440 kcal/300 mL carbohydrates [CARB] or fat [FAT]) in a randomized crossover blinded setting...
July 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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