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Diabetes and cardiac surgery

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https://www.readbyqxmd.com/read/28942979/differences-and-similarities-in-risk-factors-for-postoperative-acute-kidney-injury-between-younger-and-older-adults-undergoing-cardiac-surgery
#1
Nadim Saydy, Amine Mazine, Louis-Mathieu Stevens, Hughes Jeamart, Philippe Demers, Pierre Pagé, Yoan Lamarche, Ismail El-Hamamsy
OBJECTIVES: Acute kidney injury is a frequent complication after cardiac surgery. The purpose of this study was to assess the risk factors for acute kidney injury in patients ≤60 years of age undergoing cardiac surgery and to compare these risk factors with those identified in patients ≥65 years of age. METHODS: From 2010 to 2012, 1253 patients ≤60 years (mean age 52 ± 9 years) and 2488 patients ≥65 years (mean age 74 ± 6 years) underwent cardiac surgery...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28940985/logistic-regression-analysis-of-the-risk-factors-of-anastomotic-fistula-after-radical-resection-of-esophageal-cardiac-cancer
#2
Jinxi Huang, Yi Zhou, Chenghu Wang, Weiwei Yuan, Zhandong Zhang, Beibei Chen, Xiefu Zhang
BACKGROUND: This study was conducted to investigate the risk factors of anastomotic fistula after the radical resection of esophageal-cardiac cancer. METHODS: Five hundred and forty-four esophageal-cardiac cancer patients who underwent surgery and had complete clinical data were included in the study. Fifty patients diagnosed with postoperative anastomotic fistula were considered the case group and the remaining 494 subjects who did not develop postoperative anastomotic fistula were considered the control...
September 20, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28940961/perioperative-continuation-of-metformin-does-not-improve-glycemic-control-in-patients-with-type-2-diabetes-a-randomized-controlled-trial
#3
A H Hulst, J A W Polderman, E Ouweneel, A J Pijl, M W Hollmann, J H DeVries, B Preckel, J Hermanides
Historically, metformin was withheld before surgery in fear of metformin associated lactic acidosis. Now, this risk is deemed low and guidelines move towards continuation of metformin. We hypothesized that continuing metformin perioperatively would lower postoperative serum glucose without an effect on plasma lactate. We performed a single-blind multicenter RCT in type 2 diabetes mellitus patients scheduled for non-cardiac surgery and continued (MF+) or withheld (MF-) metformin before surgery. Main outcome parameters were the differences in perioperative plasma glucose and lactate levels...
September 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28935681/sex-differences-in-the-utilization-and-outcomes-of-surgical-aortic-valve-replacement-for-severe-aortic-stenosis
#4
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28934715/stercoral-perforation-of-the-rectosigmoid-colon-due-to-chronic-constipation-a-case-report
#5
Mustafa Fevzi Celayir, Hakan Mustafa Köksal, Mehmet Uludag
INTRODUCTION: Chronic constipation is very common in elderly patients. As a result of this situation fecaloma is also frequently seen at these ages. However, the stercoral perforation caused by fecaloma is a rare situation to occur. The rectosigmoid colon is the most affected colonic segment. It is seen in older patients with concomitant diseases and a low quality of life. PRESENTATION OF CASE: Here in this case, we have to report an 83 - year-old male patient who came to the emergency room with complaints of abdominal pain and constipation for two days...
September 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28919628/coronary-artery-bypass-graft-with-endarterectomy-and-stent-removal-in-patient-with-multivessel-in-stent-restenosis
#6
S S Husain, C M Ahmed, A B Adhikary, S A Sunny, M N Hasan
In the age of stent deployment after balloon angioplasty. In stent restenosis (ISR) has become a major concern. Various coronary interventional measures and coronary artery bypass graft (CABG) has employed to manage the ISR. Although CABG seems to offer advantages over other coronary intervention methods in patients with multi vessel ISR; lack of appropriate graftable vessels often make the surgery difficult and end up with incomplete revascularization. Coronary endarterectomy with stent removal mitigated some of the limitations of CABG but initial results of this surgical measure were not favorable...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#7
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28877948/appropriateness-of-percutaneous-coronary-interventions-in-patients-with-ischaemic-heart-disease-in-italy-the-apache-pilot-study
#8
Sergio Leonardi, Marcello Marino, Gabriele Crimi, Florinda Maiorana, Diego Rizzotti, Corrado Lettieri, Luca Bettari, Marco Zuccari, Paolo Sganzerla, Simone Tresoldi, Marianna Adamo, Sergio Ghiringhelli, Carlo Sponzilli, Giampaolo Pasquetto, Andrea Pavei, Luigi Pedon, Luciano Bassan, Mario Bollati, Paola Camisasca, Daniela Trabattoni, Marta Brancati, Arnaldo Poli, Claudio Panciroli, Maddalena Lettino, Giuseppe Tarelli, Giuseppe Tarantini, Leonardo De Luca, Ferdinando Varbella, Giuseppe Musumeci, Stefano De Servi
OBJECTIVES: To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. DESIGN: Retrospective, pilot study. SETTING: 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. PARTICIPANTS: 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics...
September 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28873075/intraoperative-magnesium-sulphate-decreases-agitation-and-pain-in-patients-undergoing-functional-endoscopic-surgery-a-randomised-double-blind-study
#9
Hazem E Elsersy, Magdy Ch Metyas, Hana A Elfeky, Ahmed A Hassan
BACKGROUND: Postoperative agitation is harmful for the patient as it may be associated with removal of catheters, nasal packs, oxygen masks and self-injury, and pose a danger to operating theatre staff. OBJECTIVE: The current study investigated the potential role of magnesium sulphate in treatment of postoperative agitation following functional endoscopic sinus surgery. DESIGN: A randomised, double-blinded, placebo-controlled trial. SETTING: ENT operating room, Menofia University Hospitals, Egypt...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28858079/laparoscopic-vertical-sleeve-gastrectomy-a-5-year-veterans-affairs-review
#10
Rahman G Barry, Farzad A Amiri, Todd W Gress, D Blaine Nease, Timothy D Canterbury
The aim of this study was to evaluate the outcomes after laparoscopic sleeve gastrectomy (SG) in a VA population.SG has recently gained popularity as a definitive bariatric surgery procedure. Data are lacking on long-term outcomes, particularly in a Veterans Affairs population.We retrospectively reviewed 223 patients who underwent SG for morbid obesity between January 2009 and June 2014. Data on length of stay, complications, interval weight loss, comorbidities, and number of therapies preoperatively and at long-term follow-up were collected...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28833518/post-sternotomy-mediastinitis-in-the-modern-era
#11
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/28833503/persistent-acute-kidney-injury-following-transcatheter-aortic-valve-replacement
#12
Charat Thongprayoon, Wisit Cheungpasitporn, Michael A Mao, Narat Srivali, Wonngarm Kittanamongkolchai, Andrew M Harrison, Kevin L Greason, Kianoush B Kashani
BACKGROUND: Acute kidney injury (AKI) and its severity after transcatheter aortic valve replacement (TAVR) have been associated with worse outcomes. Studies have shown that AKI duration (transient or persistent) affects outcomes independently of AKI severity. This study was undertaken to determine the association, risk factors, and outcomes associated with persistent AKI (pAKI) after TAVR. METHODS: Adult patients undergoing TAVR at Mayo Clinic between January 1, 2008 and June 30, 2014 were enrolled...
August 22, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#13
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28807801/effect-of-diabetes-mellitus-on-clinical-outcomes-and-quality-of-life-after-transcatheter-aortic-valve-implantation-for-severe-aortic-valve-stenosis
#14
Tomasz Tokarek, Artur Dziewierz, Agata Wiktorowicz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Pawel Kleczynski, Dariusz Dudek
BACKGROUND: Diabetes mellitus (DM) is considered a marker of poor prognosis after cardiac surgery. We sought to investigate the effect of DM on clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI). METHODS: A total of 148 consecutive patients with symptomatic, severe aortic stenosis who underwent TAVI were included. Baseline characteristics, procedural and long-term clinical outcomes, and the results of frailty and QoL assessment with EQ-5D-3L questionnaire were compared between patients with and without DM...
August 12, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28806185/graft-quality-verification-in-coronary-artery-bypass-graft-surgery-how-when-and-why
#15
Teresa M Kieser
PURPOSE OF REVIEW: The coronary artery bypass graft (CABG) operation is one of the few remaining operations/interventions on diseased arteries that are not routinely verified during or immediately after the procedure. This review answers the 'how', 'when' and 'why' of intraoperative CABG assessment. RECENT FINDINGS: More recent than new literature on this topic, is the increased interest in quality assurance of CABG. This is most likely due to reports in the last 5 years suggesting CABG superiority to percutaneous coronary intervention (PCI) for improved mid-term and long-term outcomes; for example, for patients with diabetes mellitus (Freedom Trial by Farkouh in 2012), and for patients with SYNTAX score ≥ 33 (SYNTAX Trial by Mohr in 2013)...
August 12, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28804970/arrhythmogenic-gene-remodelling-in-elderly-patients-with-type-2-diabetes-with-aortic-stenosis-and-normal-left-ventricular-ejection-fraction
#16
R Ashrafi, P Modi, A Y Oo, D M Pullan, K Jian, H Zhang, J Yanni Gerges, G Hart, M R Boyett, G K Davis, J P H Wilding
What is the central question of this study? Type 2 diabetes is associated with a higher rate of ventricular arrhythmias compared with the non-diabetic population, but the associated myocardial gene expression changes are unknown; furthermore, it is also unknown whether any changes are attributable to chronic hyperglycaemia or are a consequence of structural changes. What is the main finding and its importance? We found downregulation of left ventricular ERG gene expression and increased NCX1 gene expression in humans with type 2 diabetes compared with control patients with comparable left ventricular hypertrophy and possible myocardial fibrosis...
August 14, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28795891/experience-using-closed-incision-negative-pressure-wound-therapy-in-sternotomy-patients
#17
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28779787/effect-of-statins-on-survival-in-patients-undergoing-dialysis-access-for-end-stage-renal-disease
#18
Paola De Rango, Basso Parente, Luca Farchioni, Enrico Cieri, Beatrice Fiorucci, Selena Pelliccia, Alessandra Manzone, Gioele Simonte, Massimo Lenti
The benefit of statin therapy in patients with advanced chronic kidney disease remains uncertain. Randomized trials have questioned the efficacy of the drug in improving outcomes for on-dialysis populations, and many patients with end-stage renal disease are not currently taking statins. This study aimed to investigate the impact of statin use on survival of patients with vascular access performed at a vascular center for chronic dialysis. Consecutive end-stage renal disease patients admitted for vascular access surgery in 2006 to 2013 were reviewed...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28762900/-the-problem-of-minimally-changed-coronary-arteries-at-elective-coronary-angiography
#19
A N Sumin, E V Korok, M A Sinkov, O A Nagirnyak, L S Barbarash
AIM: to study rates and possible causes of detecting "clean" coronary arteries at elective coronary angiography. MATERIAL AND METHODS: Medical records of 711 patients who had undergone elective coronary angiography (ECAG) between 01/04 and 31/05 2014 were retrospectively reviewed. Four groups were distinguished: group 1 - patients with normal coronary arteries (n=234), group 2 - patients with coronary artery stenoses (CAS) <60% (n=94), group 3 - patients with 60-69% CAS (n=22), group 4 - patients with CAS more or equal 70% (n=361)...
April 2017: Kardiologiia
https://www.readbyqxmd.com/read/28758975/elevated-soluble-urokinase-plasminogen-activator-receptor-and-proenkephalin-serum-levels-predict-the-development-of-acute-kidney-injury-after-cardiac-surgery
#20
Jana C Mossanen, Jessica Pracht, Tobias U Jansen, Lukas Buendgens, Christian Stoppe, Andreas Goetzenich, Joachim Struck, Rüdiger Autschbach, Gernot Marx, Frank Tacke
Acute kidney injury (AKI) develops in up to 40% of patients after cardiac surgery. The soluble urokinase plasminogen activator receptor (suPAR) has been identified as a biomarker for incident chronic kidney disease (CKD). Proenkephalin (proENK) also has been shown to be a biomarker for renal dysfunction. We hypothesized that pre-surgery suPAR and proENK levels might predict AKI in patients undergoing cardiac surgery. Consecutive patients (n = 107) undergoing elective cardiac surgery were studied prospectively...
July 31, 2017: International Journal of Molecular Sciences
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