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https://www.readbyqxmd.com/read/29752842/correlation-between-duration-of-preoperative-fasting-and-emergence-delirium-in-pediatric-patients-undergoing-ophthalmic-examination-under-anesthesia-a-prospective-observational-study
#1
Puneet Khanna, Kulbhushan Saini, Renu Sinha, Niseville Nisa, Shailendra Kumar, Souvik Maitra
BACKGROUND: Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium. AIMS: The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. METHODS: In this prospective observational study, 100 children between the age group 2-6 years of American Society of Anesthesiologists physical status I or II, scheduled for examination of the eye under general anesthesia with sevoflurane were recruited...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29697537/bariatric-surgery-and-gene-expression-in-the-gut
#2
Priscila Sala, M L Corrêa-Giannella, Dan L Waitzberg
PURPOSE OF REVIEW: The current review provides an overview of recent literature on new findings related to bariatric surgery and gut gene expression. RECENT FINDINGS: Bariatric surgery modulates the expression of intestinal genes. Experimental and clinical investigations have demonstrated the association of gut rearrangement with changes in intestinal expression of genes related to glucose metabolism. Recent data suggest that bariatric surgery also affects expression of genes belonging to other pathways, including nutrient transporters and metabolism of vitamin B12, decreasing pathway-encoding genes that may contribute to vitamin B12 deficiency in the postoperative period...
April 24, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29652278/effects-of-glargine-insulin-on-glycemic-control-in-patients-with-diabetes-mellitus-type-ii-undergoing-off-pump-coronary-artery-bypass-graft
#3
Hemang Gandhi, Alpesh Sarvaia, Amber Malhotra, Himanshu Acharya, Komal Shah, Jeevraj Rajavat
Background: The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29615375/all-patients-should-be-screened-for-diabetes-before-total-joint-arthroplasty
#4
Noam Shohat, Karan Goswami, Majd Tarabichi, Emily Sterbis, Timothy L Tan, Javad Parvizi
BACKGROUND: Diabetes is highly prevalent in patients with osteoarthritis before total joint arthroplasty and presents a higher risk of adverse postoperative outcomes. However, the rate of diabetes in this population and optimal screening strategies remain unknown. METHODS: We prospectively screened patients undergoing elective total joint arthroplasty for diabetes using glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) levels. Screening was conducted within 2 time periods between 2012 and 2017...
February 19, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29558304/case-252-acute-hyperammonemic-encephalopathy-resulting-from-late-onset-ornithine-transcarbamylase-deficiency
#5
Michelle Hershman, Raymond Carmody, Unni K Udayasankar
History A 19-year-old woman with no pertinent medical history was brought to the emergency department after being found unconscious on her bathroom floor by her roommate. In the preceding weeks, she had reported intractable nausea and vomiting, for which she had been taking ondansetron. No other medications had been prescribed. The day prior to presentation, she had contacted her mother and described increasing confusion. Glasgow coma scale score on arrival in the emergency department was 4. Intravenous naloxone was administered, without immediate response...
April 2018: Radiology
https://www.readbyqxmd.com/read/29524184/development-of-de-novo-diabetes-in-long-term-follow-up-after-bariatric-surgery
#6
Zubaidah Nor Hanipah, Suriya Punchai, Stacy A Brethauer, Philip R Schauer, Ali Aminian
INTRODUCTION: While bariatric surgery leads to significant prevention and improvement of type 2 diabetes, patients may rarely develop diabetes after bariatric surgery. The aim of this study was to determine the incidence and the characteristic of new-onset diabetes after bariatric surgery over a 17-year period at our institution. METHODS: Non-diabetic patients who underwent bariatric surgery at a single academic center (1997-2013) and had a postoperative glycated hemoglobin (HbA1c) ≥ 6...
March 9, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29521181/obesity-related-metabolic-and-endocrine-disorders-diagnosed-during-postoperative-follow-up-of-slipped-capital-femoral-epiphysis
#7
Hanifi Ucpunar, Ismet Yalkin Camurcu, Serda Duman, Esra Ucpunar, Hakan Sofu, Avni Ilhan Bayhan
Background and purpose - Patients with slipped capital femoral epiphysis (SCFE) are phenotypically overweight or obese and may therefore require clinical follow-up of obesity-related disorders. We evaluated obesity-related disorders such as dyslipidemia, type 2 diabetes mellitus (DM), and vitamin-D deficiency during the postoperative period in patients with SCFE. Patients and methods - 51 patients who were operated and followed-up for SCFE and 62 healthy adolescents without SCFE (control group) were included in this retrospective study...
June 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29519226/postoperative-euglycaemic-diabetic-ketoacidosis-associated-with-sodium-glucose-cotransporter-2-inhibitors-gliflozins-a-report-of-two-cases-and-review-of-the-literature
#8
B Chacko, M Whitley, U Beckmann, K Murray, M Rowley
Sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated euglycaemic diabetic ketoacidosis (euDKA) is a serious and increasingly recognised complication of treatment with this class of oral hypoglycaemic agents and can present a diagnostic challenge, resulting in delayed recognition, inappropriate treatment and potentially life-threatening acidosis. We present two cases of patients developing SGLT2i-associated euDKA in the early postoperative period. We support ceasing SGLT2i for 72 hours preoperatively and would suggest continuing to withhold the medication until oral intake is restored, and recommend a wider awareness of SGLT2i-associated diabetic ketoacidosis (DKA) amongst patients and their healthcare providers with an emphasis on checking ketone levels irrespective of blood glucose levels in the postoperative setting...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29478825/early-postoperative-and-late-metabolic-morbidity-after-pancreatic-resections-an-old-and-new-challenge-for-surgeons-a-review
#9
REVIEW
Hans G Beger, Benjamin Mayer
The metrics for measuring early postoperative morbidity after resection of pancreatic neoplastic tumors are overall morbidity, severe surgery-related morbidity, frequency of reoperation and reintervention, in-hospital, 30-day and 90-day mortality and length of hospital stay. Thirty-day readmission after discharge is additionally an indispensable criterion to assess quality of surgery. The metrics for surgery-associated long-term results after pancreatic resections are survival times, new onset of diabetes (DM), impaired glucose tolerance, exocrine pancreatic insufficiency, body mass index and GI motility dysfunctions...
February 16, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29477991/severe-hypophosphataemia-a-rare-cause-of-postoperative-muscle-weakness
#10
Aarti Narayan, Arun Subramanian
We report a case of severe generalised muscle weakness in a 66-year-old man who underwent revision of left knee arthroplasty. On postoperative day 1, he developed non-focal muscle weakness and shortness of breath which progressed over a 6-hour period. Serum phosphorus level was severely low at 0.5 mg/dL, along with mild degree of hypokalaemia, hypocalcaemia and hypomagnesaemia. His symptoms completely resolved after emergent phosphorus replacement. The authors believe this case is of educational interest to physicians as generalised muscle weakness is an uncommon presentation of severe hypophosphataemia...
February 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29456121/establishment-of-colonic-dialysis-model-in-uremic-rats-by-right-nephrectomy-and-left-partial-nephrectomy
#11
Abdol-Mohammad Kajbafzadeh, Nastaran Sabetkish, Shabnam Sabetkish
BACKGROUND: Conventional treatments for patients suffering with end-stage renal disease (ESRD) has several disadvantages, highlighting the importance of other reproducible modalities such as colonic dialysis (CD). OBJECTIVES: The aim was to establish a CD model in uremic rats and evaluate the effect of two different peritoneal dialysis (PD) solutions. METHODS: Thirty-two male Wistar rats were randomly divided into four groups. After right nephrectomy and left partial nephrectomy, a Malone antegrade continence enema (MACE) stoma was created...
February 7, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29391105/hyperglycemia-is-associated-with-surgical-site-infections-among-general-and-vascular-surgery-patients
#12
Amy Showen, Tara A Russell, Stephanie Young, Sachin Gupta, Melinda M Gibbons
Surgical site infection (SSI) is a common cause of morbidity in general and vascular surgery patients. There is inconsistent evidence on the association of glycemic status with SSI, and its utility in predicting and mitigating SSI. General and vascular surgery patients at a public teaching hospital had the following markers of glycemic status prospectively collected: preoperative hemoglobin A1c (HbA1c) and capillary blood glucose (cBG, within six months before surgery), perioperative cBG (within 24 hours before surgery), and postoperative cBG (peak value up to 48 hours after surgery)...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29330638/predictors-of-severe-postoperative-hyperglycemia-after-cardiac-surgery-in-infants-a-single-center-retrospective-observational-study
#13
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...
April 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29324792/critical-evaluation-of-colon-submucosal-microdialysis-in-awake-mobile-rats
#14
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
#15
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
#16
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...
February 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29162977/perioperative-management-of-patients-with-diabetes
#17
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
#18
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
#19
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
#20
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
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