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https://www.readbyqxmd.com/read/29076485/-the-metabolic-optimized-fast-track-concept-preoperative-preparation-for-abdominal-surgery
#1
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
#2
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
#3
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/m(2)) 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
#4
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
#5
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/perioperative-continuation-of-metformin-does-not-improve-glycemic-control-in-patients-with-type-2-diabetes-a-randomized-controlled-trial
#6
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/28935429/glycemic-control-in-patients-undergoing-coronary-artery-bypass-graft-surgery-clinical-features-predictors-and-outcomes
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#15
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
October 20, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#16
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28681261/laparoscopic-ileal-interposition-with-diverted-sleeve-gastrectomy-versus-laparoscopic-transit-bipartition-with-sleeve-gastrectomy-for-better-glycemic-outcomes-in-t2dm-patients
#17
Serdar Yormaz, Huseyin Yılmaz, Ilhan Ece, Mustafa Sahin
BACKGROUND: Metabolic procedures provide better outcomes for obese patients with type 2 diabetes mellitus. Our aim was to compare the glycemic regulation in patients that have undergone the laparoscopic ileal interposition with diverted sleeve gastrectomy (II-DSG), laparoscopic transit bipartition with sleeve gastrectomy (TB-SG), and laparoscopic sleeve gastrectomy (LSG) throughout a 12-month follow-up period retrospectively. METHODS: This study considered patients with T2DM who underwent metabolic procedures...
July 5, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28614237/can-intravenous-steroid-administration-reduce-postoperative-pain-scores-following-total-knee-arthroplasty-a-meta-analysis
#18
REVIEW
Li-Zhi Xing, Li Li, Lan-Ju Zhang
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate whether intravenous steroids would result in reduced acute pain and postoperative nausea and vomiting (PONV) among patients undergoing total knee arthroplasty (TKA). METHODS: Electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, were searched to identify articles published from database inception to July 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28608489/continuous-glucose-monitoring-following-pancreatectomy-with-islet-autotransplantation-in-children
#19
Deborah A Elder, Jose M Jiminez-Vega, Lindsey N Hornung, Ranjit S Chima, Maisam Abu-El-Haija, Tom K Lin, Joseph J Palermo, Jaimie D Nathan
Aim was to determine whether CGM could accurately monitor blood glucose concentration in the immediate postoperative period following pancreatectomy with IAT in children. CGM was used in nine patients undergoing IAT at our institution between April 2015 and September 2016 (eight total pancreatectomy and one subtotal pancreatectomy). MAD and MARD of CGM values compared to time-matched serum blood glucose were calculated during the first 5 days of ICU admission. Goal range was defined as 70-140 mg/dL and out-of-range was >140 mg/dL or <70 mg/dL...
November 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28573554/-prevention-of-postoperative-infections-risk-factors-and-the-current-who-guidelines-in-musculoskeletal-surgery
#20
REVIEW
Christian Willy, Hayo Rieger, Marcus Stichling
BACKGROUND: Despite the many scientific and technological advances postoperative infection continues to be a large problem for trauma and orthopedic surgeons. Based on a review of the current literature, this study provides a comprehensive overview of the risk factors (RF) and possible preventive measures to control surgical site infections. METHODS: Medline search and analysis from 1968-2017 (as of 01 March 2017). Selection of trauma and orthopedic relevant RFs and comparison with WHO recommendations (global guidelines for the prevention of surgical site infection, Nov...
June 2017: Der Unfallchirurg
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