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https://www.readbyqxmd.com/read/29330638/predictors-of-severe-postoperative-hyperglycemia-after-cardiac-surgery-in-infants-a-single-center-retrospective-observational-study
#1
Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto
PURPOSE: Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. METHODS: A total of 69 infants (aged 1-12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29324792/critical-evaluation-of-colon-submucosal-microdialysis-in-awake-mobile-rats
#2
Norbert Cibicek, Jiri Ehrmann, Jitka Proskova, Rostislav Vecera
Sensors able to record large bowel physiology and biochemistry in situ in awake rodents are lacking. Microdialysis is a mini-invasive technique that may be utilized to continuously deliver or recover low-molecular substances from various tissues. In this experiment we evaluated the feasibility of in vivo microdialysis to monitor extracellular fluid chemistry in the descending colon submucosa of conscious, freely moving rodents. Following surgical implantation of a microdialysis probe, male Wistar rats were housed in metabolic cages where they were analgized and clinically followed for four days with free access to standard diet and water...
2018: PloS One
https://www.readbyqxmd.com/read/29306223/do-preoperative-oral-carbohydrates-improve-postoperative-outcomesin-patients-undergoing-coronary-artery-bypass-grafts
#3
Ömer Faruk Şavluk, Mehmet Ali Kuşçu, Füsun Güzelmeriç, Mustafa Emre Gürcü, Atakan Erkılınç, Deniz Çevirme, Halide Oğuş, Tuncer Koçak
Background/aim: The aim of this prospective study was to determine whether the preoperative oral intake of carbohydrate-rich drinks by patients undergoing a coronary artery bypass graft attenuates postoperative insulin requirements, improves postoperative patient discomfort, provides inotropic support, shortens the length of the ICU stay, and shortens the duration of postoperative mechanical ventilation. Materials and methods: This randomized prospective clinical study included 152 patients with coronary artery disease who were divided into 4 groups...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29260243/-perioperative-handling-of-antidiabetic-drugs
#4
REVIEW
J Wagner, V Luber, J F Lock, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
Diabetes mellitus is the most frequent metabolic disorder in the western world with a prevalence of 3% in adults under 65 years of age and 14.3% in adults over 65 years of age. Due to the increasing age of our population, the number of patients taking oral antidiabetic drugs has increased. Thus, operating physicians must make a risk-adapted decision whether the medication can be continued perioperatively or if certain drugs must be paused, and if so, with what risks. Operative interventions can lead to a number of metabolic shifts, which change the normal glucose metabolism...
December 19, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29162977/perioperative-management-of-patients-with-diabetes
#5
REVIEW
Vivien Leung, Kristal Ragbir-Toolsie
Hyperglycemia has long been recognized to have detrimental effects on postoperative outcomes in patients undergoing surgery. The manifestations of uncontrolled diabetes are manifold and can include risk of hyperglycemic crises, postoperative infection, poor wound healing, and increased mortality. There is substantial literature supporting the role of diligent glucose control in the prevention of adverse surgical outcomes, but considerable debate remains as to the optimal glucose targets. Hence, most organizations advocate the avoidance of hypoglycemia while striving for adequate glucose control in the perioperative period...
2017: Health Services Insights
https://www.readbyqxmd.com/read/29157765/the-effect-of-preoperative-oral-carbohydrate-solution-intake-on-patient-comfort-a-randomized-controlled-study
#6
Emel Çakar, Emel Yilmaz, Ekrem Çakar, Hakan Baydur
PURPOSE: The study was conducted to investigate the effect of preoperative oral carbohydrate loading on the preoperative discomforts and postoperative complications of patients undergoing elective thyroidectomy. DESIGN: A randomized controlled clinical trial. METHODS: Ninety patients scheduled for thyroidectomy were divided into three groups: (1) those receiving a carbohydrate-rich drink (CHD), (2) those receiving an overnight 5% glucose intravenous infusion, and (3) those fasting from midnight...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29076485/-the-metabolic-optimized-fast-track-concept-preoperative-preparation-for-abdominal-surgery
#7
V M Looft, A V Dmitriev
In recent years the protocols of Enhanced Recovery After Surgery (E.R.A.S.) have been introduced into clinical practice and actively used. The goal of E.R.A.S. is to increase recovery, decrease complications and reduce length of stay after surgery through optimization of perioperative management. One of the key elements of E.R.A.S. is Metabolic Optimized Fast Track Concept (MOFA). It is aimed at the reduction of the period of preoperative fasting and at the activation of glucose transport inside the cell. It involves the administration of combined carbohydrate-protein-glutamine drinks which results into decreased insulin resistance in the early postoperative period...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29067250/basal-insulin-therapy-is-associated-with-beneficial-effects-on-postoperative-infective-complications-independently-from-circulating-glucose-levels-in-patients-admitted-for-cardiac-surgery
#8
P M Piatti, M Cioni, A Magistro, V Villa, V G Crippa, E Galluccio, B Fontana, S Spadoni, E Bosi, L D Monti, O Alfieri
BACKGROUND: Although hyperglycemia is a strong predictor of postoperative infective complications (PIC), little is known about the effect of basal insulin therapy (BIT) per se on PIC. AIM: To evaluate if there is an association between BIT, independent of glucose levels, and a possible improvement of PIC during the perioperative cardiosurgery period (PCP). METHODS: In 812 patients admitted for cardiac intervention and treated with a continuous intravenous insulin infusion (CIII) for hyperglycemic levels (>130 mg/dl), a retrospective analysis was performed during the PCP (January 2009-December 2011)...
March 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29058241/the-factors-affecting-lower-urinary-tract-functions-in-patients-undergoing-laparoscopic-sleeve-gastrectomy
#9
Haci Murat Cayci, Sedat Oner, Umut Eren Erdogdu, İdris Nas, Evren Dilektasli, Murat Demirbas
BACKGROUND: We prospectively assessed changes in the lower urinary system functions of women with morbid obesity following laparoscopic sleeve gastrectomy and the factors affecting these changes. METHODS: Data from 40 females who had undergone laparoscopic sleeve gastrectomy due to morbid obesity (body mass index, BMI ≥ 40 kg/m2) between January 2014-2016 at S.B.U. Bursa Yuksek Ihtisas Training and Research Hospital were prospectively evaluated. The presence of comorbidities, onset of obesity, smoking, American Society of Anesthesiologists (ASA) score, pre and 12-month postoperative weights and BMIs, fasting blood glucose (FBG), blood urea nitrogen, creatinine, insulin, homeostatic model assessment-insulin resistance (HOMA-IR) test results, overactive bladder survey (OAB-Q) scores, volume of urination, and Qmax values obtained from uroflowmetry studies were recorded and assessed...
October 23, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28975077/the-effects-of-dexmedetomidine-administration-on-postoperative-blood-glucose-levels-in-diabetes-mellitus-patients-undergoing-spinal-anesthesia-a-pilot-study
#10
So Hui Yun, Yun Suk Choi
BACKGROUND: Dexmedetomidine (DEX) is an α2-adrenergic receptor agonist with sedative and sympatholytic effects. It inhibits the stress response and insulin secretion. Therefore, postoperative changes to blood glucose levels were investigated when DEX was intraoperatively infused for sedation purposes in diabetic patients under spinal anesthesia. METHODS: Twenty diabetic patients were randomly allocated to two groups (n = 10). Group A patients were infused with DEX at a dose of 0...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28963101/chronic-psychological-stress-accelerates-vascular-senescence-and-impairs-ischemia-induced-neovascularization-the-role-of-dipeptidyl-peptidase-4-glucagon-like-peptide-1-adiponectin-axis
#11
Limei Piao, Guangxian Zhao, Enbo Zhu, Aiko Inoue, Rei Shibata, Yanna Lei, Lina Hu, Chenglin Yu, Guang Yang, Hongxian Wu, Wenhu Xu, Kenji Okumura, Noriyuki Ouchi, Toyoaki Murohara, Masafumi Kuzuya, Xian Wu Cheng
BACKGROUND: Exposure to psychosocial stress is a risk factor for cardiovascular disease, including vascular aging and regeneration. Given that dipeptidyl peptidase-4 (DPP4) regulates several intracellular signaling pathways associated with the glucagon-like peptide-1 (GLP-1) metabolism, we investigated the role of DPP4/GLP-1 axis in vascular senescence and ischemia-induced neovascularization in mice under chronic stress, with a special focus on adiponectin -mediated peroxisome proliferator activated receptor-γ/its co-activator 1α (PGC-1α) activation...
September 28, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28940961/peri-operative-continuation-of-metformin-does-not-improve-glycaemic-control-in-patients-with-type-2-diabetes-a-randomized-controlled-trial
#12
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 for fear of metformin-associated lactic acidosis. Currently, however, this risk is deemed to be low and guidelines have moved towards the continuation of metformin. We hypothesized that continuing metformin peri-operatively would lower postoperative serum glucose level without an effect on plasma lactate levels. We performed a single-blind multicentre randomized controlled trial in people with type 2 diabetes mellitus scheduled for non-cardiac surgery and continued (MF+ group) or withheld (MF- group) metformin before surgery...
September 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28935429/glycemic-control-in-patients-undergoing-coronary-artery-bypass-graft-surgery-clinical-features-predictors-and-outcomes
#13
Judson B Williams, Eric D Peterson, Álvaro S Albrecht, Shuang Li, Sameer A Hirji, T Ferguson, Peter K Smith, Renato D Lopes
PURPOSE: Critically ill patients with hyperglycemia have worse prognosis. The degree to which glycemic control is achieved following CABG surgery and the association with clinical outcomes is not well understood. MATERIALS AND METHODS: We studied patients undergoing higher risk CABG surgery at 55 US hospitals. Good glycemic control was defined as 70-180mg/dL in the first 24h postoperatively. Generalized estimating equations logistic regression models were used to assess the relationship between glycemic control and clinical outcomes after adjusting for baseline characteristics...
September 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28914872/-the-efficacy-of-desmopressin-in-the-treatment-of-central-diabetes-insipidus-after-resection-of-chiasmo-sellar-region-tumors
#14
L I Astaf'eva
Central diabetes insipidus (CDI) is a neuroendocrine disease, the pathogenesis of which is associated with abnormal secretion of the antidiuretic hormone. One of the specific causes of CDI is neurosurgical resection of chiasmatic-sellar region tumors. AIM: to study the efficacy and safety of desmopressin in CDI patients after resection of chiasmatic-sellar region (CSR) tumors. MATERIAL AND METHODS: Examination and treatment of patients were performed at a hospital for 7-14 days after surgery and then were continued after discharge...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28871492/frequency-of-antibiotic-associated-diarrhea-and-related-complications-in-pediatric-patients-who-underwent-hypospadias-repair-a-comparative-study-using-probiotics-vs-placebo
#15
Ciro Esposito, Agnese Roberti, Francesco Turrà, Mariapina Cerulo, Giovanni Severino, Alessandro Settimi, Maria Escolino
This study aimed to evaluate the effectiveness of probiotics (Lactobacillus rhamnosus GG), as a preventive measure of antibiotic-associated diarrhea (AAD) in children who underwent hypospadias repair and its clinical consequences on postoperative outcome, comparing the group treated with probiotics + antibiotics with two control groups (only antibiotics and antibiotics + placebo). We performed a prospective, randomized, placebo-controlled study with three groups of patients (30 boys for each group) who underwent hypospadias repair in our unit from March 2016 to December 2016...
September 4, 2017: Probiotics and Antimicrobial Proteins
https://www.readbyqxmd.com/read/28799484/pharmacology-and-perioperative-considerations-for-diabetes-mellitus-medications
#16
Stephen Aniskevich, J Ross Renew, Ryan M Chadha, Joan M Irizarry-Alvarado
BACKGROUND: Given the prevalence of diabetes mellitus in modern society, health care providers are frequently tasked with managing glucose control in the perioperative period. When determining perioperative diabetes management, the clinician must balance the need to maintain relative euglycemia at the time of surgery with preventing hypoglycemia or hyperglycemia in a fasting surgical patient. This balance requires an understanding of the pharmacology of these medications, the type of surgery, and the patient's degree of diabetic control...
August 10, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28794087/euglycaemic-ketoacidosis-a-potential-new-hazard-to-plastic-surgery-day-case-and-inpatient-procedures
#17
Aseel Sleiwah, Michael McBride, Claire E Black
A woman aged 44 underwent elective standard abdominoplasty and bilateral mastopexy (superiorly based pedicle with vertical scar) following weight loss of 8.5 stone (53.9 kg) over a 5-year period. She had type 2 diabetes and her antidiabetic medications included metformin, liraglutide and empagliflozin. Towards the end of the first postoperative day, she reported gradual onset of nausea, vomiting and abdominal pain. Her condition continued to deteriorate overnight, becoming tachycardic and tachypnoeic. Urgent investigations showed severe diabetic ketoacidosis with euglycaemia...
August 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28780045/sleeve-gastrectomy-with-duodenojejunal-end-to-side-anastomosis-in-the-treatment-of-type-2-diabetes-the-initial-experiences-in-a-chinese-population-with-a-more-than-4-year-follow-up
#18
Xiaojiao Ruan, Weijian Zhang, Huajie Cai, Ru Zheng, Feizhao Jiang, Hengliang Zhu
BACKGROUND: Gastric bypass has been thought to be associated with a risk of gastric cancer, particularly in Asia. Sleeve gastrectomy with duodenojejunal end-to-side anastomosis (SG-DJESA) was suggested to be a better-designed procedure to avoid this risk, and it also has other advantages. OBJECTIVE: We aimed to evaluate the clinical efficacy and feasibility of SG-DJESA in the treatment of nonobese patients with type 2 diabetes (T2D). SETTING: University Hospital, China...
October 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28732549/intraperitoneal-lactate-pyruvate-ratio-and-the-level-of-glucose-and-glycerol-concentration-differ-between-patients-surgically-treated-for-upper-and-lower-perforations-of-the-gastrointestinal-tract-a-pilot-study
#19
Jonas E Sabroe, Anne R Axelsen, Mark B Ellebæk, Bjarne Dahler-Eriksen, Niels Qvist
BACKGROUND: Secondary peritonitis is a condition associated with high morbidity and mortality. Continuous postoperative monitoring of patients to ensure timely intervention to treat complications without delay is important for survival and outcome. We aimed to (1) investigate potential differences in postoperative intraperitoneal biomarker levels between patients with upper and lower gastrointestinal tract lesion, and (2) compare postoperative biomarker levels between complicated and uncomplicated patients...
July 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28726650/-modified-system-of-thromboprophylaxis-in-patients-with-surgical-profile
#20
O Kolotylo, I Venher, S Kostiv, A Iftodiy
The aim of the study was to reduce the incidence of postoperative thrombosis in the veins of the inferior vena cava basin under planned surgical interventions by using a modified thromboprophylaxis method. Two groups of patients were studied in a total of 698 patients who underwent a risk assessment of postoperative venous thromboembolism (PVTE) using the J. Caprini scale (2012). According to the patients indicated in determining the degree of risk of HTHP development according to the J. Caprini scale, the level of surgical stress was simultaneously determined...
June 2017: Georgian Medical News
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