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Diabetes and cardiac surgery

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https://www.readbyqxmd.com/read/28427873/risk-factors-for-hospital-admission-after-anterior-cruciate-ligament-reconstruction
#1
Steven L Bokshan, Steven F DeFroda, Brett D Owens
PURPOSE: To determine patient and surgical risk factors for admission after anterior cruciate ligament reconstruction (ACLR) using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. METHODS: All instances of ACLR from 2005 to 2014 from the ACS NSQIP prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine which patient demographics and medical comorbidities were associated with admission after surgery...
April 17, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28419746/factors-for-postoperative-complications-following-pressure-ulcer-operation-stepwise-multiple-logistic-regression-analysis
#2
Hyun Ho Han, Jun Gul Ko, Jong Won Rhie
Patients with pressure ulcers are generally older, have a long hospital stay and often have a variety of comorbidities. The decision to perform surgery for pressure ulcer management can be difficult because of concerns about the risk of postoperative complications. The aim of this study was to analyse the relationship between comorbid conditions and surgical outcomes in order to guide patient selection for pressure ulcer surgery. In 57 patients, data on age, defect size, operating time, hospital stay, body mass index, surgical site, mobility state, cardiac ischaemic history, diabetes, renal failure, ventilator dependency, tracheostomy state, use of haemodilution therapy and cancer were evaluated using stepwise multiple logistic regression analysis to determine the relationships between variables...
April 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28402472/direct-sternal-administration-of-vancomycin-and-gentamicin-during-closure-prevents-wound-infection%C3%A2
#3
Martin Andreas, Moritz Muckenhuber, Doris Hutschala, Alfred Kocher, Florian Thalhammer, Paul Vogt, Tatjana Fleck, Guenther Laufer
OBJECTIVES: Deep sternal wound infection is still a major complication in patients undergoing cardiac surgery. We previously identified mammary artery harvesting as a risk factor for decreased antibiotic tissue penetration. In addition, other risk factors including diabetes may inhibit sufficient tissue penetration of perioperative antibiotic prophylaxis. A novel closure protocol applying 2 topical antibiotics and further recommendations for sternal wiring was introduced at our department to decrease the incidence of sternal wound infections...
April 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28396614/can-takotsubo-cardiomyopathy-be-diagnosed-by-autopsy-report-of-a-presumed-case-presenting-as-cardiac-rupture
#4
Andrew Mitchell, François Marquis
BACKGROUND: Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is myocardial rupture...
2017: BMC Clinical Pathology
https://www.readbyqxmd.com/read/28373177/glycemic-control-status-after-percutaneous-coronary-intervention-and-long-term-clinical-outcomes-in-patients-with-type-2-diabetes-mellitus
#5
Jin Kyung Hwang, Seung Hwa Lee, Young Bin Song, Joonghyun Ahn, Keumhee Carriere, Mi Ja Jang, Taek Kyu Park, Seung-Hyuk Choi, Jeong Hoon Yang, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND: Data on the association between glycemic control after percutaneous coronary intervention and clinical outcomes are limited and controversial in diabetic patients. METHODS AND RESULTS: We studied 980 patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention using drug-eluting stents. Based on 2-year glycosylated hemoglobin A (HbA1c) levels, we divided patients into 2 groups of HbA1c<7.0 (n=489) and HbA1c≥7.0 (n=491). Propensity score-matched analysis was performed in 322 pairs...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28345769/best-practice-policy-statement-on-urodynamic-antibiotic-prophylaxis-in-the-non-index-patient
#6
REVIEW
Anne P Cameron, Lysanne Campeau, Benjamin M Brucker, J Quentin Clemens, Gregory T Bales, Michael E Albo, Michael J Kennelly
AIMS: Antibiotic prophylaxis before urodynamic testing (UDS) is widely utilized to prevent urinary tract infection (UTI) with only limited guidance. The Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) convened a Best Practice Policy Panel to formulate recommendations on the urodynamic antibiotic prophylaxis in the non-index patient. METHODS: Recommendations are based on a literature review and the Panel's expert opinion, with all recommendations graded using the Oxford grading system...
March 27, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28341355/comparison-of-clinical-and-electrocardiographic-predictors-of-ischemic-and-nonischemic-cardiomyopathy-during-the-initial-evaluation-of-patients-with-reduced-%C3%A2-40-left-ventricular-ejection-fraction
#7
Nathaniel R Smilowitz, Arvind R Devanabanda, George Zakhem, Sohah N Iqbal, William Slater, John T Coppola
Invasive coronary angiography is routinely performed during the initial evaluation of patients with suspected cardiomyopathy with reduced left ventricular function. Clinical and electrocardiographic (ECG) data may accurately predict ischemic cardiomyopathy (IC). Medical records of adults referred for coronary angiography for evaluation of left ventricular ejection fraction ≤40% from 2010 to 2014 were retrospectively reviewed. Patients with myocardial infarction (MI), previous coronary revascularization, cardiac surgery, or left-sided valvular disease were excluded...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28302078/early-serum-creatinine-accurately-predicts-acute-kidney-injury-post-cardiac-surgery
#8
Keren Grynberg, Kevan R Polkinghorne, Sharon Ford, Fiona Stenning, Thomas E Lew, Jonathan A Barrett, Shaun A Summers
BACKGROUND: Acute Kidney Injury (AKI) is a well recognized complication of cardiac surgery. It is associated with significant morbidity and mortality. The aims of our study are twofold; 1. To define the incidence of AKI post cardiac surgery. 2. To identify pre-morbid and operative risk factors for developing AKI and to determine if immediate post operative serum creatinine (IPOsCr) accurately predicts the development of AKI. METHODS: We prospectively studied 196 consecutive patients undergoing elective (on-pump) cardiac surgery...
March 16, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28302002/preoperative-cardiac-risk-assessment-in-patients-undergoing-liver-transplant-due-to-hepatocellular-carcinoma-should-it-be-different
#9
Haldun Muderrisoglu, Kerem Can Yilmaz, Emir Karacaglar, Ugur Bal, Alp Aydinalp, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Liver transplant is a high-risk surgery for cardiac events. The risk of 30-day major cardiac adverse events is estimated at more than 5%. In this retrospective study, we evaluated our preoperative cardiac risk assessment approach. MATERIALS AND METHODS: We evaluated 58 adult patients who underwent liver transplant between May 2011 and May 2015. Preoperative cardiac risk factors and results of diagnostic tests were noted. Patients were divided into 2 groups: patients with or without hepatocellular carcinoma...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28299450/the-prevalence-of-post-thyroidectomy-chronic-asthenia-a-prospective-cohort-study
#10
Gregorio Scerrino, Giuseppina Melfa, Cristina Raspanti, Andrea Attard, Sergio Mazzola, Roberto Gullo, Sebastiano Bonventre, Marco Attard, Gianfranco Cocorullo, Gaspare Gulotta
PURPOSE: Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. METHODS: A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre- and post-operative thyroid hormone levels, and BMI outside the normal range...
March 15, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28292646/follow-up-of-elderly-patients-with-urogenital-cancers-evaluation-of-geriatric-care-needs-and-related-actions
#11
Silvio Monfardini, Sara Morlino, Riccardo Valdagni, Mario Catanzaro, Ardit Tafa, Barbara Bortolato, Giovanni Petralia, Elisa Bonetto, Elisa Villa, Stefano Picozzi, Maria Cristina Locatelli, Giuseppe Galetti, Andrea Millul, Yasmin Albanese, Elisa Bianchi, Claudia Panzarino, Francesca Gerardi, Ettore Beghi
OBJECTIVES: To investigate a comprehensive geriatric assessment (CGA) with subsequent investigation of healthcare patterns in older patients with urological cancers undergoing initial surgery or radiotherapy, to verify the usefulness of the incorporation of geriatric principles in future care plans. MATERIAL AND METHODS: This is a prospective cohort study. From November 2011 to March 2015, CGA was offered to all patients aged 70+ years treated with radiotherapy or surgery at seven tertiary centers...
March 11, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28289072/down-regulation-of-mir-15a-b-accelerates-fibrotic-remodelling-in-the-type%C3%A2-2-diabetic-human-and-mouse-heart
#12
Shruti Rawal, Pujika Emani Munasinghe, Prashanth Thevkar Nagesh, Jason Kar Sheng Lew, Gregory T Jones, Michael J A Williams, Philip Davis, Dick Bunton, Ivor F Galvin, Patrick Manning, Regis R Lamberts, Rajesh Katare
Aim: Myocardial fibrosis is a well-established cause of increased myocardial stiffness and subsequent diastolic dysfunction in the diabetic heart. The molecular regulators that drive the process of fibrotic events in the diabetic heart are still unknown. We determined the role of the microRNA (miR)-15 family in fibrotic remodelling of the diabetic heart.Methods and results: Right atrial appendage (RAA) and left ventricular (LV) biopsy tissues collected from diabetic and non-diabetic (ND) patients undergoing coronary artery bypass graft surgery showed significant down-regulation of miR-15a and -15b...
May 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28283230/outcomes-after-mitral-valve-repair-a-single-center-16-year-experience
#13
James M Tatum, Michael E Bowdish, Wendy J Mack, Adrienne M Quinn, Robbin G Cohen, Amy E Hackmann, Mark L Barr, Vaughn A Starnes
OBJECTIVE: To evaluate outcomes after mitral valve repair. METHODS: Between May 1999 and June 2015, 446 patients underwent mitral valve repair. Isolated mitral valve annuloplasty was excluded. A total of 398 (89%) had degenerative valve disease. Mean follow-up was 5.5 ± 3.8 years. Postoperative echocardiograms were obtained in 334 patients (75%) at a mean of 24.3 ± 13.7 months. RESULTS: Survival was 97%, 96%, 95%, and 94% at 1, 3, 5, and 10 years...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28275421/treating-a-structural-heart-disease-using-a-non-structural-approach-role-of-cardiac-pacing-in-hypertrophic-cardiomyopathy
#14
Bernard Benjamin P Albano, Erdie C Fadreguilan, Jeffrey M Chua, James Ho, Ana Beatriz Medrano
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease characterized by a thickened non-dilated ventricle in the absence of another cardiac or systemic condition. Its most important hemodynamic consequence is left ventricular outflow tract (LVOT) obstruction. The primary management strategy of this condition is surgical septal myectomy, but an acceptable alternative treatment in patients who are not suitable for (or who refuse) surgery is alcohol septal ablation (ASA). However, in patients with unfavorable coronary anatomy which precludes ASA (i...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28266749/the-effect-of-glucagon-like-peptide-1-and-glucagon-like-peptide-2-on-microcirculation-a-systematic-review
#15
REVIEW
Nikolaj Nerup, Rikard Ambrus, Joanna Lindhe, Michael P Achiam, Palle B Jeppesen, Lars B Svendsen
OBJECTIVE: Glucagon-like peptide-1 (GLP-1) and -2 (GLP-2) are gut-derived hormones used in the treatment of diabetes type-2 and short bowel syndrome, respectively. GLP-1 attenuates insulin resistance and GLP-2 reduces enterocyte apoptosis and enhances crypt cell proliferation in the small intestine. In addition, both hormones have vasoactive effects and may be useful in situations with impaired microcirculation. The aim of this systematic review was to provide an overview of the potential effects of GLP-1 and GLP-2 on microcirculation...
March 7, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/28265893/management-of-hyperglycemia-and-diabetes-in-orthopedic-surgery
#16
REVIEW
Funke Akiboye, Gerry Rayman
An increasing number of orthopedic operations are being carried out in an older population in whom the prevalence of diabetes is dramatically increasing. People having surgery with diabetes and hyperglycemia are at increased risk of post-operative complications. The peri-operative risks have been well demonstrated for cardiac surgery and, more recently, for orthopedic surgery. This paper considers the issues surrounding orthopaedic surgery in patients with diabetes and the significance and management of hyperglycemia in the peri-operative period...
February 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28251160/prognostic-analysis-for-cardiogenic-shock-in-patients-with-acute-myocardial-infarction-receiving-percutaneous-coronary-intervention
#17
Mao-Jen Lin, Chun-Yu Chen, Hau-De Lin, Han-Ping Wu
Cardiogenic shock (CS) is uncommon in patients suffering from acute myocardial infarction (AMI). Long-term outcome and adverse predictors for outcomes in AMI patients with CS receiving percutaneous coronary interventions (PCI) are unclear. A total of 482 AMI patients who received PCI were collected, including 53 CS and 429 non-CS. Predictors for AMI patients with CS including recurrent MI, cardiovascular (CV) mortality, all-cause mortality, and repeated-PCI were analyzed. The CS group had a lower central systolic pressure and central diastolic pressure (both P < 0...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28244936/ischemic-optic-neuropathy-in-cardiac-surgery-incidence-and-risk-factors-in-the-united-states-from-the-national-inpatient-sample-1998-to-2013
#18
Daniel S Rubin, Monica M Matsumoto, Heather E Moss, Charlotte E Joslin, Avery Tung, Steven Roth
BACKGROUND: Ischemic optic neuropathy is the most common form of perioperative visual loss, with highest incidence in cardiac and spinal fusion surgery. To date, potential risk factors have been identified in cardiac surgery by only small, single-institution studies. To determine the preoperative risk factors for ischemic optic neuropathy, the authors used the National Inpatient Sample, a database of inpatient discharges for nonfederal hospitals in the United States. METHODS: Adults aged 18 yr or older admitted for coronary artery bypass grafting, heart valve repair or replacement surgery, or left ventricular assist device insertion in National Inpatient Sample from 1998 to 2013 were included...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28242257/exendin-4-inhibits-structural-remodeling-and-improves-ca-2-homeostasis-in-rats-with-heart-failure-via-the-glp-1-receptor-through-the-enos-cgmp-pkg-pathway
#19
Jingjing Chen, Dandan Wang, Fangai Wang, Shaobo Shi, Yuting Chen, Bo Yang, Yanhong Tang, Congxin Huang
The glucagon-like peptide-1 receptor (GLP-1R) agonist exendin-4 is a long-acting analog of GLP-1, which stimulates insulin secretion and is clinically used in the treatment of type 2 diabetes. Previous studies have demonstrated that GLP-1 agonists and analogs serve as cardioprotective factors in various conditions. Disturbances in calcium cycling are characteristic of heart failure (HF); therefore, the aim of this study was to investigate the effect of exendin-4 (a GLP-1 mimetic) on the regulation of calcium handling and to identify the underlying mechanisms in an HF rat model after myocardial infarction (MI)...
April 2017: Peptides
https://www.readbyqxmd.com/read/28229912/mid-diastolic-left-ventricular-volume-and-mass-normal-values-for-coronary-computed-tomography-angiography
#20
Daniel Juneau, Fernanda Erthal, Owen Clarkin, Atif Alzahrani, Ali Alenazy, Alomgir Hossain, Joao R Inacio, Girish Dwivedi, Alexander J Dick, Frank J Rybicki, Benjamin J W Chow
BACKGROUND: The adoption of prospectively ECG-triggered acquisition coronary computed tomography angiography (CTA) has resulted in the inability to measure left ventricle (LV) end-diastolic volume and LV ejection fraction. However other prognostic measures such as LV mass and LV mid-diastolic volume (LVMDV) can still be assessed. The objective of this study is to establish normal reference values for LVMDV and LV mass. METHODS: Left ventricular mid-diastolic volumes and LV mass were prospectively measured in 2647 consecutive 'normal' patients undergoing prospectively ECG-triggered coronary CTA...
February 10, 2017: Journal of Cardiovascular Computed Tomography
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